1/09/2016

The Only Time I've Wanted To Shave Someone's Head. Carefully.

In dealing with head lice, there is a quick - almost immediate - solution.  Shave your head. Lice hold on to the scalp by holding on to the hair.  Eggs are laid on the hair.  Nits and lice need the warmth of the hairy scalp to develop and grow.  No hair, no lice.

But I'm not really recommending this.  Not because you wouldn't look good with a shaved head (I think you would probably look great) but because shaving your head is a very drastic response to a problem that is usually easily remedied with a few combings over a couple of weeks.  The time put into a bit of lice combing is significantly shorter than the time needed to grow your hair back.

However, there was one time that I wish I could have shaved a head.

I was asked to do lice removal on a wonderful woman who had long beautiful hair.  Her hair was her crown, her glory - she was so proud of her hair.  She had a really bad case of head lice; the kind that makes you think she has had it for years. From far away her hair was lovely but as soon as you got close, you could see rows and rows of dark brown lice, bug upon bug. It wasn't the worst case of head lice I had seen but it was clear that her head lice would not be dealt with in just a couple of combings. And as I started, it was also clear that her problem was bigger than expected.

Her head was one big scab.  Months, maybe years,  of bites and scratching had left her head inflamed and infected.  Puss oozed from the sores and every time I touched her head, she flinched with pain.  I told her she needed to see a doctor.  She refused and demanded that I comb which I did. I tried to be as gentle as possible but it was clear that she was very uncomfortable. As I continued, I noticed that the glands in her neck were swollen.  I asked her if she had any other unusual symptoms besides itching and she told me she had regular chills and body aches. She wasn't sleeping well and had no energy.  I told her I felt she was having an allergic reaction to the lice and that her scalp looked infected. This concerned me because I knew she also had other conditions that compromised her health.  I explained my concerns but she wouldn't see a doctor.  Maybe she didn't want anyone else to know about her head lice. Maybe she was afraid that the doctor would tell her to cut her hair. Either way, she was adamant that she would be fine with a bit of lice combing.

Because her scalp was in pain, she could not handle the combing for very long.  I gave her my lice comb and told her that she needed to comb her hair daily, as much as she could handle, and reiterated her need for medical attention.  She refused to see the doctor and had me come to her home for one more short visit the following week which was not enough to complete the lice removal process. I asked her if she had used the lice comb.  She said she had been too tired to do the combing.  I told her she absolutely had to see a doctor. She again refused. I suggested she shave her head to get rid of the lice and allow her scalp to heal. She got upset. I did what I could that day but there were no more follow up visits.

Head lice are not normally a health issue.  They are an annoyance.  But the wounds caused by this woman's scratching became infected and her body started reacting to the infection and all the saliva and feces they left there by hundreds of lice.  As I have said before, there are things much worse than head lice.  Please, never let the stigma of head lice or the pride of your appearance keep you from getting the help you need. If your head lice has been going on for months or years, you should get support.  Talk to a friend or family member. Find a trusted professional.  And if you are having any symptoms besides a bit of itching, please talk to a doctor.

17 comments:

Anonymous said...

I'm a school nurse with a school full of lice issues. I'm looking for some good credible info to send home to my parents. Preferably in English and Spanish.

Katlin Francisco said...

Hi! I don't know where else to contact you so I figure here may work. My 7 year old ended up with lice. I found 3 or 4 hatchlings and 10+ eggs I would say. Some of the eggs and a couple of the hatchlings were very tiny. I checked her dry first and removed as many of the nits as I could find and a few of the hatchlings. I then treated her with rid, I believe, and conditioned after that and then combed through her hair again. On the wet check I got a couple more nits but did not see anything else. I checked, double checked, and triple checked ev every piece of hair for anymore nits but nothing. Are we done with this infestation or could they still come back? Also, where was the adult louse that had to of laid the eggs in the first place? I have a 3 year old daughter and she was clean so was their father and me. I am worried that I can't be this lucky for it to be over so quickly. Thank you for any help!!

Haley Hansen said...

http://www.thepetitionsite.com/743/521/426/lets-bring-back-the-%22no-nit%22-policy-to-brevard-county-schools/

Please help us get back the No Nit policy!

Cathy, the Nice Lice Lady. said...

Sorry, Haley, but I DO NOT endorse no-nit policies as they give parents a false sense of security which I think can actually increase the problem in our schools. Research has been done on these policies and they are simply not effective in the fight against head lice. Before the nits are even noticed, most people have had head lice for 3 months or so and have already been spreading head lice. On the other hand, having a nit does not mean that a person has an active case of head lice. I have been to homes where nits were present but they were old and inactive - there were no lice on the head.

I think no-nit policies can often cause harm. Besides ostracizing children amongst their peers, these policies can cause serious problems for parents. I remember a call I received from one parent whose daughter was not allowed to return to daycare because they thought they saw a nit. Because the mother did not have daycare, she had to call in sick to work and they fired her. I worked with another family whose child was sent home from school because they thought they saw a nit; they sent her home in the middle of the day and her parents were not home so she sat outside of her locked house in the winter. In both these situations, the unnecessary panic of head lice led to some bad choices that had consequences far worse than head lice.

Also, if a school has a no-nit policy, when can the child return to school? Who decides that? Some schools say that a child can return to school when they have had a lice "shampoo". But most of these pesticide based treatments have become ineffective and children return to school with an active case of head lice. Also, studies have shown that many professionals, even doctors, misdiagnose head lice. I have heard stories of school secretaries having to be the school gatekeepers when it comes to checking the children for lice and why should these often inexperienced and misinformed people have the power to refuse our children's education?

I truly, truly understand your frustration with this issue. However, though lice are an inconvenience, they are not a public health issue. And lice can be dealt with easily - even if other parents are not diligent in addressing this problem with their children, you can be diligent in addressing this problem with your children. By diligent, I do not mean doing any extra cleaning or laundry - that's just a waste of energy. The best thing you as a parent can do is to do weekly lice checks (via a quick wet combing) with your children. That way, if your children do have head lice, you will catch it before it even becomes an issue. Early detection is the best prevention.

SwissTabby said...

Where can we come to visit you (since we read that you are unfortunately not doing house calls). This is our family's first lice battle and my 8 yr old has had one female louse, a small/immature louse and half a dozen nits we have combed out and have treated her and her sister and myself as well as many many loads of laundry, bagging of toys and vacuuming. I would feel more confident having an expert have a look and ensure our scalps are clean.

SwissTabby said...
This comment has been removed by the author.
SwissTabby said...

Following

SwissTabby said...

Where can we come to visit you (since we read that you are unfortunately not doing house calls). This is our family's first lice battle and my 8 yr old has had one female louse, a small/immature louse and half a dozen nits we have combed out and have treated her and her sister and myself as well as many many loads of laundry, bagging of toys and vacuuming. I would feel more confident having an expert have a look and ensure our scalps are clean.

Cathy, the Nice Lice Lady. said...

Hello! Sorry, I'm not doing lice checks for the public right now. But you don't need me anyway - you are already doing the combing, getting out the lice and nits, and dealing with the problem. I would not recommend any more "treatments" - most have lost their effectiveness and it is the combing that really deals with the problem. Continue doing wet combing on your 8 year old every few days (with a good lice comb on conditioned hair) until you have had 2 weeks of finding nothing. Look at articles on this blog for more info on how to do this.

And please, please, please stop doing the loads of laundry, the bagging of toys, the extra laundry, etc. Research has shown that has no effectiveness in the fight against head lice and it is just a waste of your time; I know from working with many families that it is a tremendous waste of energy and contributes to the fatigue, panic, and despair that some people develop over this. I know that lice give you the creeps and you want to do all you can to rid your home of them, but they are not in your home, stuffed animals, or clothes. The only place they are going to thrive is on the head. Get them off the head and the cycle will stop.

Breathe. Get some rest. Get some sleep. Take a break for a few days - you have probably gotten the big bugs off the head which means your child is not going to spread head lice to anyone right now. Comb again in a few days. If you have missed anything in today's combing, you will catch it in the next combing once it is big enough to comb out but before it is big enough to procreate or leave the head. With the exception of doing lice combing every few days, your life should go back to normal. Trust what you find (or do not find) in the comb. You've got this.

Anonymous said...

Hi Cathy

I have been worried about lice for a little bit and have found your blog very helpful. I know you do not do lice checks or treatments anymore but was hoping I could still reach out to you for a question. One of my coworkers found out she had lice about two months ago. She combed them out and has been lice-free since, at least I believe she has. Since I am a nervous person I started spot checking my own hair and only found some mild dandruff and I wasn't itching. However, a couple of weeks ago my head started itching and I have gotten very worried about the possibility of lice. I was unable to find a lice comb but have been doing wet combing checks with a fine tooth plastic comb (the spines are about 1mm apart) hoping that I would be able to spot at least a live louse if any were present. The comb has come out clean each time (3-4 checks in the past two weeks) I am not sure what next steps to take. Should I assume that I am lice-free or order a decent lice comb online?
Thanks!

Stephanie said...

^ to Anonymous: I would get a real lice comb, those plastic ones will do nothing for your head if you have nits. The nits stick to the hair and are quite hard to remove. We are going on Week 2 of de-licing and I am thinking of getting the Nit Free Terminator comb. The first one we got from Walgreens was ok, but I still felt like it wasn't "fine" enough. Another way to get checked is to have a friend look through your scalp at these spots: base of the back of the neck, behind the ears, and at the middle of your scalp.

Jesika said...

How do you treat the house after doing you steps

Anonymous said...

Read the rest of this blog. You don't do anything to the house. Just get the lice off of the head.

Unknown said...

I want to say "thanks". With all the information on the Internet I have been nuts for two weeks since finding live in my 4yr Olds head. I can finally turn off the washer / dryer and breath a breath of relief. I will push on and focus on wet combing. Thank you for the peace of mind.
Sandy

Water Chemical Solution said...

Nice post.
Than you for your information.
Chemical Treatment Solution

Anonymous said...

Hi. I have been battling with head lice for a few months now. I got it off a friend's child. I've tried every treatment I could find; nit combing even though I have very thick hair etc. Eventually I went to see a doc who proposed that I shave my head. As a woman, I found the suggestion mortifying. But after another week of hopelessness I gave in and shaved my entire head. Apart from looking terrible; the creatures are still there! Only smaller. What do I do? Is it possible to completely shave the head with no small hairs left? I tried 3 times

Anonymous said...

Hi Cathy, I have was wondering if you recommend something to take out the nits from the terminator comb. The teeth are so hard since they are metal. I combing out my 8th grader but it's hard to clean the comb. Thank you for your amazing information:)