The Zen of Head Lice

When I was doing lice removal in people's homes, I always found that my main job was not actually the lice removal - this was really something the families could do themselves.  Where I was most helpful was in calming panic.  Because parents generally didn't call me until they were at the end of their rope after having tried every so-called treatment paired with marathon sessions of cleaning and laundering and wiping everything else from their schedule.  Their panic was causing them not only to freak out about the lice of today but they imagined many more weeks and many more dollars spent on this lice frenzy. They pictured lice living on everything in their home forever. I loved that I could just come in and say,

"You can stop all this now. Breathe."

Not because I was coming in to save the day but because the things they were doing were not actually helping.  I was able help families step away from their panic and future worries and guide them to focus on the simple steps they could take each day to address the problem. I tried to help them to be mindful about head lice.

Jon Kabat-Zinn says mindfulness means paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.  For me, this means to look at head lice objectively for what they are and what they aren't.  They are a bug - a parasite that lives on the heads of humans (other creatures have their own lice.).  They just cause itching (and not death which is what I assume some people think based on their reaction to lice.) They are not the result of uncleanliness.  They are not a virus that is transmitted through the air or even passed through inanimate objects. They are not living in your furniture or stuffed animals.  If you have them, you will find them on the head.

Being mindful when you have head lice also means that you look at yourself and others objectively too.  Take a moment and check your own body's reactions and emotions to the people around you.  How do you feel about the person that you think you got head lice from?  Are you angry?   How do you feel about the parent of the child who first had head lice in the classroom? Are you resentful?  Think of the people you hang around - your friends, co-workers, or the parents of the friends of your children.  Do you feel judged?  Think of yourself.  Do you feel shame?

Regarding the person that you think gave you head lice, they didn't choose to have head lice and there is no guarantee that you didn't get it from someone else. If fact, you may have actually been the first one to get it and they just noticed it on their head before you did. Before you judge others for not dealing with the problem, think of how many "treatments" you have already tried to combat your head lice?   Don't you think others are doing their best, just as you are?

Head lice are not a result of someone doing something wrong any more than mosquitoes or ants are.  They are just a part of life on earth.  So feel free to release any anger, resentment, judgment, or shame that they stir up in you and continue to release those feelings whenever you feel them surfacing.

Another thing to think on regarding mindfulness and head lice is self care.  When we pay close attention to what we are feeling, we can give ourselves what we really need.  Finding out that you have head lice can be a trauma when you don't know how easily it can be taken care of.  If discovering that you have head lice in the home is a shock to you, then you need to treat the shock.  Not by avoiding the problem and pretending it isn't there but by equipping yourself so that you can stay in control - of the head lice and of yourself.  Don't waste time in cleaning and laundering but spend a little time wet combing the head every couple of days until the head lice are gone.  You can read posts on this blog for more tips on how to do that. And tend to your own care through it all.  For each minute that you spend on head lice removal, plan for a minute of self care at another time.  What restores you? A hot bath? A nap?  A nice walk?  A good meal?  If you are dealing with head lice for the first time, then this is something new and with everything new there is a learning curve; with every change comes stress.  Do not allow this stress to be the kind that overwhelms you. With mindfulness, this stress can be the kind that will motivate you.  To be effective and helpful and patient and gracious. 

Now take your partner's hand and start singing "Kum By Yah".  Just kidding.  Mindfulness is not just for the meditators and the yoga instructors. It's for all of us as we muddle through this life and it helps us focus on what we actually have to work with. And I'm positive that you have all you need to deal with the inconvenience of head lice.   Namaste.

No Cleaning, No Cry

I am a bit baffled.  Lately, I've been getting comments from people who say they love reading the blog but that they are exhausted by all the cleaning that you have to do when you have head lice.

Which once again makes me wonder if they have really read many posts.

Because if you read the research, you know that extra cleaning doesn't do anything in the fight against head lice.  Lice are not spread by inanimate objects in any significant way.  Lice researcher Ian Burgess has basically said that if a louse falls off your head, it is either dead or dying. Those suckers are designed to stay on the head.  In the 2010 paper, "Indirect Transmission of Head Lice via Inanimate Objects", researchers Deon V. Canyon and Rick Speare conclude: "The control of head lice should focus on the head, not on the environment.  Head lice scholars should focus on how to limit reinfestation rather than providing erroneous control advice...The promotion of inanimate objects that play an epidemiologically important role in head lice dispersal is unsupported by the evidence base..."

What does this mean?  You are not going to get head lice from your couch.  Or your bedding. In this paper, the authors call bedding a "hostile environment" for head lice.  Which means, lice don't want to leave your head because it has the climate (the right temperature) and the sustenance (your blood) that it needs to survive.  Lice will not find this on your cool linen sheets. Or on a hair brush.  Or on a hat.  So don't waste your time cleaning or laundering these things beyond your normal cleaning routine. Excessive cleaning won't help in the fight and it certainly could hurt (exhaustion, burnout, stress, anxiety, extra expenses, etc.)  When I did lice removal in the home, I would sometimes hear, "I didn't have time to do the lice combing what with all of the cleaning and laundry I've had to do." Constant cleaning makes us feel like we are dealing with the problem and being effective, but it is a sad illusion. It is the combing that gets rid of the head lice, not the cleaning.

You are going to get head lice from the head of someone else who has it. Head to head.  And you can't even be 100% certain who that person is, so don't waste your time worrying about that either. Follow the advice of the researchers.  Focus on the head, not on the environment.



 

What's the least you can do to feel sane?

Last spring, my friend's daughter got head lice.  Naturally, my friend called me for reassurance. Though my friend and I have had many discussions about head lice, her perspective on head lice changed when it actually made an appearance in her own house.

She said, "I know that the research says that doing cleaning won't help. But I want to clean.  I want to vacuum everything, including the children. I want to do laundry.  It would make me feel better."

I like a clean home as much as the next person, but I know the cleaning marathons that are triggered by the discovery of head lice.  All other activity (including sleep) is discontinued in and out of the home.  What's worse is that people actually cut back on the time they spend in lice combing because they are too exhausted from their newly adopted morning-to-night rituals (get kids up, strip beds, throw bedding in wash, vacuum mattresses, vacuum room, throw pajamas in wash, throw pillows in the dryer...all before the morning coffee.) Though NONE of this helps, I understand that it is our natural survival instincts that get us moving in a crisis.  Being busy makes us feel better.  Knowing the panic that ensues in a home that just discovers these uninvited guests, I asked my friend a question:

"What is the LEAST you can do to still feel sane?"

My friend already knew that she needed to put the time and effort into a thorough wet combing of her daughter's head every couple of days over the next 2 weeks and that this would already give her plenty of work to do.  But in her mind, she wanted to do more.  In answer to my question, she said, "The pillows.  I think my rational mind would let me give up most of the cleaning, but I know I couldn't rest if I didn't change my daughter's pillow case every day." 

"Ok, as long as you know that this activity will have no effect on your daughter's head lice, right?"

"I know."

So my friend resisted the demon of excessive cleaning and even stopped changing the pillowcase after a couple of days.  She used no chemical treatments and simply used a proper metal lice comb on her daughter's wet, conditioned hair.  Though she combed over a 2 week period, no lice or eggs were seen after the 3rd combing. When I congratulated her on the success of her efforts, she admitted that she had doubted that the solution could be so simple.  (Simple but not easy; even though things get easier and faster as you go, keeping up with the combing is still a pain in the arse.) I asked her why she stopped washing her pillowcases every day.  She said that as she did more combings, her confidence in her own abilities to detect and remove the bugs and eggs grew every day.  She was pleased that I had steered her away from doing more and being less effective.

If you have just discovered head lice in your home, get informed before you do or spend anything. If you are reading this blog for the first time, check out the other posts.  Learn about wet combing. Read the research links.  Think with your head based on the most current knowledge and try not to give into cleaning urges.  But if you just can't resist, then choose your battles wisely.  Ask yourself the question, "What is the least I can do to feel sane?" Not the least you can do in the combing/picking department - nothing will relieve you of this necessary task - but what is the least you can do in the home. Less time cleaning means more time combing. Get a good comb, do the combing, and trust the process.

Pediculosis Biebitis or Please Stop Wasting Your Time!

Last month, Justin Bieber came to my city.  I didn't go to see him because he's a bit young for me and my daughters are more into those fabricated bands from the Disney Channel. All of this, of course, made me think of head lice...

What's worse than the itch? Burnout.

Recently, I spoke with two mothers who were dealing with head lice in their families (and dealing with it very well, I might add.)  In our conversations, it became very clear to me that these women were now experts on head lice.  They knew what they were looking for and were willing to put in the time and the right kind of effort to deal with this problem. I truly appreciate this kind of vigilance when it comes to head lice.  As I have said before, we must not underestimate these little guys - even with all of our modern weapons, we have more cases of head lice than ever before.  Head lice need to be taken seriously.

However, we must resist hyper-vigilance.Y'know, the kind of vigilance that makes us crazy.  Where we lose sleep over head lice, assume every itch is a new bite, start over combing or over treating our hair, restrict our regular activities,  keep everyone up late and wake them up early to do nit-picking, and clean our homes for hours every day.  I know we seem to feel better when we DO something, but the only thing this hyper-vigilance will do is make us sick. ( I'm speaking mostly to the mothers - sorry Dads, I have yet to find a two-parent home where the father is the main person who takes control over the family head lice.)

As I have said before, when feelings of lice anxiety are leading you down this path, get control of your feelings and look at the facts:

• Extra house cleaning has no proven effectiveness in the fight against head lice. Or, I should say it has evidence-based ineffectiveness.  Studies have shown that extra cleaning does nothing in this fight.
• Keeping children out of school, daycare, or other activities is not necessarily helpful; no-nit policies have been proven to be ineffective in keeping head lice out of these places.
• Head lice in most industrialized nations have developed a resistance to pesticidal treatments.
• Most alternative treatments  have little or no proven effectiveness.
• The over-washing, over-combing, and over-treating of hair can often be the cause of scalp irritation - it can be the cause of itching and/or skin reactions.

As I say again and again on this blog, the way you deal with head lice is to manually remove the bugs and eggs on the head.  To do this effectively, try to get the following things:

1. Time - Not the 10-hour marathon horror stories that I hear from some parents.  I mean, you need to know that you will be dealing with this for weeks and there is no getting around it, not even if you hire a lice professional.  We all can miss something, so some time should be put into combing/picking every 2 or 3 days until you have had 2 weeks with no sightings of bugs or eggs. The amount of time you need to spend in this endeavor will decrease as the weeks go on.
2. A good lice comb.  There have been effective nit-pickers throughout the years who never had the benefits of a good metal lice comb, but for the amount of time you save, I always recommend that you try to get one.  Not a necessity, but exceptionally helpful when used in wet combing.
3. Good light. Natural or artificial, light directed on the head really makes it easier to see what's going on.  For me, an inexpensive head lamp is a blessing.  It brings you directed light wherever you go and keeps your hands free for combing and picking.
3. Perspective. This is just head lice.  It is not the plague.  You are not unhygienic or unclean if you have it. Head lice are simply a reality in our world.  They have been around for ages and I expect we will still be dealing with them in the ages to come. They are a pain in the rear, but they don't have to be a tragedy if you don't let them. 

Trust that you have what it takes to deal with this problem.  Don't panic or start putting your family through a frenzy of frantic cleaning and unnecessary restrictions.  Never let head lice keep you from getting sleep, eating well, and engaging in enjoyable activities.  Never let head lice drain you financially or put your employment at risk.  Push through that initial feeling of panic.  Find a good friend to share your experience with.  Take a breath. Be gentle with yourself.  I know you can do this.

How do you get lice? From someone else's head.

Click on this link to a great study that supports the idea the head lice are NOT effectively spread through inanimate objects (clothing, furniture, pillowcases, hats, brushes, etc.). This study is from the Anton Breinl Centre for Public Health and Tropical Medicine at James Cook University, Austrailia. My favourite sentence from the conclusion is:

"We conclude that the control of head lice should focus on the head and not on the environment."

Incidently, this study also mentions how long lice can live without a meal:

Head lice are like clutter.

In his book, "It's All Too Much", home organziation guru Peter Walsh challenges the notion that the answer to clutter is more storage. To avoid having to get rid of items, or to avoid having to make decisions about all our stuff, we buy into new "storage solutions" - more baskets, file cabinets, shelving and boxes. However, in the end, these do nothing to deal with the real issue - the clutter itself. In the end, to really deal with clutter, we have to find a way to actually have less of it.

This makes me think of how some people deal with head lice. They want to deal with the problem, but they want to do everything they possibly can to avoid actually having to remove the head lice. They buy "treatments", "shampoos", and concoct home remedies. And then, when they still find bugs living on the head, they call me and ask, "Which treatment should I use next?" Or, they spend all of their energy on cleaning their home from ceiling to cellar because of head lice paranoia but can't be bothered to actually deal with the activity on the scalp.

To quote Peter Walsh, "Enough already!" Forget the expensive solutions. If you have head lice, deal with the real issue - the head lice itself. It is only when you take the time to actually remove the bugs and eggs off of the head that you will see progress. And by dealing with the real problem right from the start, you will save yourself time and money in the end.

Don't waste your time on the sidelines. Go where the action is.

Head lice are a stupid nuisance. Picking out every egg and bug is time consuming. Checking for lice activity on a daily basis is a chore.

The problem is, with most people I talk to, picking and checking isn't the problem. What most people find absolutely exhausting is all the house cleaning and laundry. Hours and hours of vacuuming, washing bedding, bagging stuffed animals, or whatever.

Here's a tip: DON'T DO IT.

I mean it. There is no evidence that suggests that cleaning your home will reduce your chance of re-infestion on your head. And there IS evidence to suggest that if you have taken the lice off of the head, but don't clean the home, your chances of getting head lice again are no greater than getting it from the general public.

If my children bring home head lice (they have brought it home from school - I don't bring my work home with me), do you know what I clean? I CLEAN THEIR HEADS OF HEAD LICE. That's where ALL the action is. I don't do any excess cleaning. Well, I do pour boiling water over the brushes and combs, though there is even research that shows I don't even need to do that. To be honest, I don't even wash their blankets and sheets (unless they were due for a washing anyway). I don't put away their stuffed animals. I don't even pull out my vacuum with the exception of when I do my regular house cleaning each week because it's nice to see the floor once in a while.

I am unrelenting when it comes to picking and checking their heads and I spend a considerable amount of time doing this. But I don't go crazy cleaning my house over head lice. And this saves me a lot of time. Head lice are only a problem when they are on your head. Make sure that 99.9% of your time is spent working to get them off of the head and then you won't have to worry about having them in the home.

No need to get dirty with your lice.

There is a phrase that people tell me all the time:
"I know that head lice prefer clean hair to dirty hair."

When someone has head lice, she often feels dirty and finds comfort in this misleading statement. We need to reassure ourselves that we are clean people. And part of the sentiment of the statement is true - head lice is not a hygiene issue. People with clean hair (and clean clothes, and clean homes) are as likely to get head lice as anyone else.

The circulation of this belief also stems from the fact that globs of goop do make things a bit more difficult for the louse. It is harder to maneuver around slimy, oily, goopy hair. So, people mistakenly think that head lice will not thrive in dirty hair. But do you know anyone who lets their hair get that dirty? Where globs of grease are dripping down their neck? No, you probably don't. Even if you didn't wash your hair for two weeks, it would never get that dirty. And even if it did, just because the restaurant takes longer to get to, that doesn't mean the lice are not going to eat. In hair clean or dirty, those bugs are going to get to your scalp and they will do just fine for themselves, thank you.

So for all of you folks who think that postponing your shampooing will assist you with your lice problem, you are sadly mistaken. Dirty hair will not prevent you from getting head lice, nor will it slow them down if you already have them. Please keep your scalp clean. Especially if I'm the one who is going to be looking through it. Much appreciated.

Calm down. Lice don't like to live on faux suede.

Spraying your house/furniture/belongings with pesticides for head lice is bad for five reasons:

1. Lice live on the head.  Period.  Don't waste your time cleaning your home any more than you normally do.
2. You shouldn't be bringing these harmful chemicals in your home. These chemicals are more dangerous to your family's health than any head lice.
3. Pesticides are not effective in the fight against head lice. Studies have shown that fumigating for head lice will not decrease your chances of becoming reinfested.
4. These chemicals are not necessary. You don't even need to vacuum anything. 
5. Fumigating costs a lot of money. You should put your hard-earned money toward treatments that have an excellent success rate (like my lice removal services!).

Don't go crazy cleaning your house.  Save your energy for dealing with the place that lice actually live and thrive - on the head.