Quick tip: How do you clean a lice comb?

Wipe it with toilet paper or paper towel.  If something is stuck between the teeth, never pry them apart. Clean it out with dental floss.  If you want to sterilize the comb between users, put it in a cup. Pour boiling water over it and let it sit for a couple of minutes.

Hair conditioner...is there anything it can't do?

Here's another point for hair conditioner as a cheap tool in the fight against head lice! I already knew that hair conditioner helps dissolve nit glue as well as, if not better than, the commercial products.  But there's a wee study that showed it might even kill the lice!

The study (HERE)  is from 2004 (so I'm surprised I never saw this before).  They took 8 people for whom other lice treatments were not effective and slathered their hair in conditioner for 2 hours. Then they did the same thing a week later.  In the 8 subjects, it was 100% effective in killing their head lice. The author suggests that the conditioner may block the spiracles or breathing holes of the lice. We don't know what it did to the nits but if conditioner can help dissolve nit glue, I'm sure it does some damage to nits as well.

This study may be teeny but it shows once again, that hair conditioner is your friend in the fight.  And since it is inexpensive, safe, easily attainable, and something I already recommend that you use in wet combing, I have no problem with you giving it a try.  (I still recommend the combing though. Get those bugs and eggs off your head!)

(One word of caution:  Anytime I see people put some creamy or oil based solution on their head for a long time to battle head lice, they tend to want to cover it up with saran wrap or a shower cap or something to keep it from being so messy.  Whatever you do, do not go to bed with your head wrapped in plastic or wrap up the head of a young child.  It can have tragic consequences.)

Why I still say wet combing is a clear choice even when the research is murky.

When I was doing head lice consultations, I never recommended any commercial "shampoos" or pesticidal treatments to deal with the infestation.  I always recommended wet combing.

But does using only wet combing really work?

Earlier this year, I read a literature review that can be found on  the Canadian Paediatric Society website, among other places. It reviews the research on different methods and products for eliminating head lice infestations.  It mentions wet combing and says that "There is little evidence to support wet combing as a primary treatment for head lice."

In this report, there are two studies mentioned, both from 2002.  In one study, wet combing got rid of the lice in only 38% of the people treated.  In the other study, adding wet combing to those treated with permethrin seemed to offer no benefit.  I couldn't find the studies mentioned in the article.

This would be discouraging to me if I didn't also know of other studies where wet combing shows effectiveness:

Hill N, Moor G, Cameron M, Butlin A, Williamson M, Bass, C. Single blind, randomised, comparative study of the Bug Buster kit and over the counter pediculicide treatments against head lice in the United Kingdom. BMJ 2005;331:84 (Bug busting is just a commercial wet combing kit.)

Tebruegge M, Runnacles J. Is wet combing effective in children with pediculosis capitis infestation? Arch Dis Child 2007;92:818–20.

Of course, in my own experience time and time again with head lice, wet combing works. Period.

But wet combing is not a chemical solution that you dose out. It is a technique and no two people are going to do it exactly the same way or use the same lice combs.  We should expect to get different results between studies.

What makes wet combing the most effective for me though is that you can do it again and again.  This alone increases its effectiveness in my book. If you buy a good comb, it is there for you to use whenever you need it.  No running out in the middle of the night to find a open drugstore to buy a "shampoo".  You just grab your comb and start combing.  I can do a combing whenever I want and as often as I want (unlike with pesticides which can have side effects and where there is a limit to how much and often you can use them.)

And wet combing is just so much cheaper.  A good comb costs less than the "shampoo" needed for one treatment. I used to feel so bad for families who thought they were finally rid of their head lice only to get it months later when it started going around their child's classroom again. They would always be stressed out about the anticipated costs of buying all those products.  I was always happy to tell them that they didn't have to spend oodles of money if they did wet combing.  (The comb in the picture is a good one at Walmart.  It's $10.47 CAD.)

Wet combing does take some time but that time will decrease each time you do it.  And again, most commercial 'shampoos' still recommend combing and multiple treatments so you aren't really saving time by using them. (Another great reusable tool in the fight against head lice is your hair dryer.)

Check out other posts for how to wet comb.  Worry less about perfecting a technique and just get combing.