Maybe a tiny bit of good can come from a very bad situation.

As I write this, the world is still dealing with the COVID-19 pandemic.  Each country is taking their own measures to address this virus.  I live in Canada where I think our governments have handled it all in a relatively thoughtful, organized, and evidence-based manner.  That doesn't mean we are out of the woods yet.  We are still waiting for the second wave of this pandemic and our numbers have already started climbing again.

It's funny - the internet is full of people claiming their rights have been violated because of physical distancing and the expectation to wear masks in public.  When faced with a deadly virus (a virus that has killed and debilitated so many, a virus that we can have and spread without even knowing it) so many people just ignore the science and the news reports and still flock to the malls, restaurants, beaches, and family gatherings.

But when someone gets head lice, watch out!  Many of these same people will spare no effort or expense to rid their home and their little ones of this quite harmless parasite.  I've seen people fumigate their furniture, shave the heads of everyone in the household, spend countless sleepless nights vacuuming from floor to ceiling, and washing anything and everything that can fit in a washing machine in hot water and bleach. They keep their children home from school, cancel play dates and swimming lessons and spend time trying to figure out who they got it from (contact tracing!). These excessive efforts around head lice are astounding and often unfortunate because (a) unlike COVID-19, head lice are not a public health threat, (b) those costs and efforts are not necessary or even effective and (c) I've seen many a well-meaning parent get completely burned out from giving up money, sleep, and sanity in doing what they thought was the right thing in the head lice battle. 

I think that if most people were freaked out about COVID-19 in the same way that they are about head lice, we would have had this thing beaten already.   Unfortunately, COVID-19 is still going strong and no matter how tired we are of these (cue the over-used phrase) unprecedented times and our wishing won't make it go away.  For some of us, its inconvenient and annoying.  For others, its uncertain and stressful.  For others, it's tragic and heartbreaking.

It is hard to find the good in all of this bad.  Still, as one of the privileged ones who can work from home, I have found moments of blessing.  I like having more time with my children.  I like the words of encouragement sent to me by friends and family and the acts of service and courage that we've seen throughout the world.  Somehow, in the midst of the darkness, some light breaks through.

Regarding head lice, it is my hope that physical distancing will have an positive effect on this problem as well. Head lice are shared through head-to-head contact and if people keep their distance and manage the lice in their homes through effective measures like regular combing, the head lice won't have anywhere to travel to. Head lice are not shared through bedding or pillows, toys or clothing.  Head lice are not like a microscopic virus that can live for long on surfaces or linger in the air.  We can see them.  We know how to treat them.  They are a pain in the behind but they are manageable.

I don't like the phrase 'social distancing' because we are social creatures who need connection for our health, but I can get on board with physical distancing.  It has been a proven tool in the fight against the coronavirus.  And maybe, just for this limited time and if people are smart about it, it will reduce the spread of head lice too.

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.

Smartphones - is there nothing they can't be blamed for?

The head line for this article is "Smartphones Blames for Dramatic Rise in Head Lice as Schoolchildren Gather Together to View Screens".  I had an instant reaction to it because I thought "Are they saying lice are being transmitted via smartphones?  Smartphones are inanimate objects and head lice wouldn't go on them!"  Then I read further and realized that it was about children having higher instances of head lice when they have their own smartphones or tablets and experts guess that this is because they are gathering close together to watch something on the small screen.  Though higher transmission around this particular activity is just a guess, I think this makes sense as the idea that lice are transmitted from head to head contact is proven. And it really is head touching head - don't believe this article when they use the unhelpful choice of words "allowing the bugs to jump between heads" because as we all know, head lice can't jump.

One thing to note though - the researchers were somehow able to determine that taking selfies was not a significant contributor to this stat.  I don't know how this was determined but it also makes sense to me.  The head to head contact of a selfie is brief and I think it is less likely that a louse would take the risk of leaving one warm head for another in this short period of time.

I would love to read the research on all of this but I could not find the original study with these claims.  (Update:  I found it.)And I really hope that no one becomes hyper-vigilant against children having personal electronic devices just because of this study.  While smartphones and tablets are often blamed for causing children to be isolated or disconnected from in-person relationships, here's one example where they are bringing children together.  Let's leave the children to their own devices (see what I did there?) within healthy limits for media use, encourage closeness, and do regular wet combing lice checks to prevent any lice sharing from becoming a problem.

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.

Just when I thought I was out...they pull me back in!

Your child comes home with head lice.  Instead of freaking out, you did the right thing.  You got informed. You got a good lice comb and started the wet combing. You didn't waste time doing unnecessary and ineffective things like extra cleaning, extra laundry and bagging up items. And within a few combings of no longer seeing any eggs or bugs, you thought, "I got this!  I've beaten head lice."

 

And then, the next day during what you think will be a super-quick combing, you find a nit. It must be old, right?  And then you comb a couple of more times and low and behold, you find a tiny louse.

 

You sigh, smile,  and say the serenity prayer.  Or, more realistically, you say, "What the !$#*&!!! Are you freakin' kidding me!?!?!" 

 

Snap.  You lose it.

 

I just want you to know that you don't have to.  If you reading this blog, then I'm certain you are dealing with head lice.  Let me assure you that with each combing it will get better and better.  But let me also assure you that finding a nit or a louse days after you thought you were rid of the problem is very common and is, in my mind, to be expected.  Because even a good lice comb can miss something the first time around. Or the second.  New eggs and new lice are often too small to be picked up by the lice comb. 

 

If you are going through the very unpleasant experience of finding a sign of head lice after you thought you had beaten it, please remember the following:

1. It took you months to get head lice.  Beating it will require an intentional but manageable effort over the next few weeks.  Don't burn yourself out, but don't give up.  Just remember you are in a marathon, not a sprint.  Pace yourself.
2. If you found something, it doesn't mean that you have failed.  In fact, it means the opposite; it proves the combing is working. 
3. It also means you are outrunning the lice cycle.  Lice hatch and as they grow, you can get them out with your lice comb. With the combing that you are doing every few days, you will still get them out before they can lay their own eggs.
4. Just because you found something, it doesn't mean that you are in any way back at square one. A few head lice does not an infestation make.  You are still ahead of the game and all of the hard work you have put into this is paying off. 

One other thing I should let you know is that even if you have beaten this round of head lice, you can always get a brand new case of head lice.  So, if you find head lice again, it may not be because you didn't deal with it properly the first time. It could just be that you got it again.  Lucky you. (At this point, my children would say that I'm being a 'Mommer Bummer' - it's like a 'Debbie Downer' but more maternal).  That's why it is important that even when you do beat your current case of head lice, you do regular lice checks via wet combing.

You do have this.  Really.  If you found another bug, don't think of this as a setback.  Think of this as progress. Because you can always manage the head lice as long as you can manage your own emotions and expectations.

Head Lice 2016: Can't we all just get along?

 In the days after the polarizing American election, we are being reminded by politicians, activists, celebrities, and late-night hosts to hold on to hope.  We must continue to speak up for those who do not have a voice but we cannot stoop to the level of the haters.  We must sort through the madness and appeal to the good in each person.  It is so easy live in fear and point fingers but we must stop and let sanity prevail. This is good advice to remember for pretty much everything in life. 

Even head lice.

A lot of commenters who weigh in on this blog spend a considerable amount of energy on being upset with the people that they feel gave them the head lice.  They are either mad at their child's school for not adopting a no-nit policy, or they are mad at the parents of their child's friend who they don't feel is dealing with their child's head lice effectively, or they are mad at the roommate/family member who will not allow them to check their head for lice. They get furious because now they feel they have to ban their child from going to their friend's house, or they feel they now have to put their child's hair up whenever they go to school, or they have to avoid sitting on THAT couch.  It's bad enough that their own head lice is taking up their time and energy - now they feel they have to change their life because someone else isn't changing theirs in dealing with their head lice.


I get it.  Head lice sucks.  And resentment can easily build when you think that you are the only one taking the problem seriously.


But before you go and have a stern talk with that person that you think is not being responsible about their head lice problem, please consider a few things.

Regarding schools, no-nit policies do not reduce the number of cases of head lice. They just don't.  Because nobody goes looking for lice and nits until the itch starts.  And if a child has not had head lice before, they might not even see or feel anything until they've had lice for 3 months or so.  So, even when no one thinks head lice is in the class, it may already be there. I know that some of you wish that we had school nurses who checked everyone for head lice every week, but seriously, that would just be a huge waste of resources. Parents can check their own kids. We need schools to be spending money on education and health authorities to be spending more money on things that actually address real health problems (By the way, I'm all for vaccinations!)

And what about that friend/cousin/study buddy/soccer coach that you are certain gave your child head lice.  You may be enraged at them but unless you saw that person pull a live louse off of their head and drop it on your child's scalp saying "Mwahahaha!" with an evil grin, you cannot be sure that they gave your child head lice, or that they even have it (unless they tell you).   And if you know they have lice, do you think they wanted it?  They are not spreading it on purpose and they want to be rid of it as much as you do and just because you can't see them dealing with it, that doesn't mean that they aren't.  And if they swear that they don't have it, what are you gonna do?  Tackle them and give them a combing?  Will that make your own lice go away any faster?

When I was a child, I never got head lice.  But now almost everyone I know has their own head lice story.  People don't get head lice because they are dirty or spread it because they are neglectful.  Head lice happens where humans connect and regardless of who gave it to you, the only thing you can control is your own actions.

And I hope your actions are kind.  Let your child go to his friend's house.  Don't freak out if your roommate sits in your chair.  Don't cancel those soccer practices.  Head lice are a bother, for sure, but not a health issue and the melt down doesn't come from the bug - it comes from the energy we spend on frenzied cleaning and angry paranoia.  If you've changed your whole routine because of head lice, that's on you, not on the bug or your neighbour.  You don't have to comb for 6 hours straight because you are not going to get it out in one sitting anyway.  You don't have to clean from morning to night because that doesn't affect your head lice problem at all.  When faced with the challenge of head lice, practice mindfulness - control your emotions and give grace to yourself and others.  If you think your problem may have come from someone you know, gather up all the love, patience, and humour you have and start a accepting conversation.  If they aren't ready for it, don't be defensive - wish them well and let them know you're their for them should they change their minds.

Let love trump hate in every area, even when dealing with these bugs. Together, can we beat head lice?  Yes, we can! 

I didn't know him. But I liked him.

Thank you to the commenter who let me know about the death of Rick Speare, researcher, doctor, veterinarian and photographer of my favourite lice pictures.  If you would like to know more about this amazing man, here's his Wikipedia page, and if you would like to donate to his memorial fund at James Cook University, you can do so here.

 

 

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.