It could just be dry scalp...but take a good look.

My son has a very dry scalp with quite a bit of dandruff. The winter weather makes it worse and his flakes are actually sticky - they don't brush off that easily. But they are flakes.

Usually dandruff brushes away. For those times when the flakes stick to the hair, how can you tell that it is not nits (lice eggs)? Well, eggs are very uniform in size and shape - ALWAYS the same and they are always glued to the hair. Dandruff can be very different in size and shape and usually can be easily brushed or blown away.

Also, if you have nits, you probably have bugs. If you have nits, go looking for ma and pa bug.

To Cut Or Not To Cut...

Does having long hair increase your chances of getting head lice and more difficult to get rid of it? Increase your chances? Maybe, as longer hair has a longer reach and can brush the hair of others more easily. More difficult to detect and get rid of? Another maybe, but don't reach for the scissors. You just need to take more time to deal with the problem. There are things you can do to reduce your chance of infestation and increase your chances of removal.

First, putting the hair up in a braid, a bun, or a ponytail is a good idea. This will help to keep the hair from going all over the place and brushing against others who have head lice. If the hair already has little "guests" crawling around it, putting the hair up will help keep the lice from travelling.

Second, if the person with long hair already has head lice, the purchase of a good lice comb is a worthwhile investment (and the combs that come with the lice treatments don't count!). Read about my favourite comb, the LiceMeister, here. With lice combs, you have to comb from root to tip in one continuous motion. If you stop, you give the bugs that you have scooped up a chance to crawl off of the comb. So separate the long hair into small, manageable sections, remove all the tangles with a normal brush or comb, and then use the lice comb on wet hair one small section at a time. Wet hair helps immobilize the bugs; you can add a bit of hair conditioner throughout the hair to prevent it from drying while you are combing.

After you have combed through every strand of hair, you NEED to go through the hair again, strand by strand and manually pick out any bugs or eggs that the comb has missed. Read my blog post about nit picking right here. If you are still not sure what you are looking for, look at some pictures here.

Something you should know. It is unlikely that any nit (egg) that is more than a few inches from the scalp will hatch as newly laid eggs are right near the scalp. You may want to remove them all for cosmetic reasons, but you really just need to direct your energies to activity near the scalp.

With long hair, this whole process can take hours, so take lots of breaks, and don't be afraid to do it over a couple of days. Lice can only lay up to 10 eggs a day, and even with multiple bugs, you can pick faster than they can lay. Just keep combing/picking everyday until you get to the point where you see no bugs or nits. Then, keep checking thoroughly for another 7 days, just in case you missed something.

Once the person with long hair is lice free, make sure you do regular lice checks. These checks can be done quickly, but you must be sure to really lift up all the hair and peek in all different areas of the scalp. Do the quick check every day and a thorough check once a week. If you see new lice activity, do thorough combing, picking, and checking everyday until you have removed the problem.

So think twice before you cut the long hair - you may be in for a longer battle but it still takes longer to grow out the hair again than it does to just deal with your lice problem.

I have a small problem with Alberta Health Services...

My daughter got another notice from school that someone in her class has head lice (no, it wasn't her). We get these green information sheets sent home fairly frequently. Maybe you've seen these information sheets before. These handouts have been created by someone at Alberta Health Services (formerly Capital Health in Edmonton). I think it is great that notices are sent home. I don't like all of the information given:

The pamphlet says: "You will need...Shampoo, 1% Permethrin lice treatment, and a regular comb or brush."
Oh please. I fight head lice all the time. I do not use ANY lice topical treatments. None. Zippo. This is not a "need". Even if you did use the lice treatment, the directions on the pamphlet are different than the ones given in the box. Whose advice should you follow? I would think you should follow the advice of the maker of the product. If you use the product, that is. Which I don't.

"Nits that are more than 1/2 inch from the scalp will not hatch."
Not necessarily so, though anything past a few inches is certainly not viable.

"In fact, lice really like clean hair"
Lots of people say this and you can read one of my old posts about this idea here.

"Wash hats, scarves, combs, brushes, hair barrettes, bed sheets and pillow cases in hot soapy water."
I used to recommend this too.  But don't do it.  It is a waste of your energy and not proven to have any effectiveness.  Lice don't want to be on things.  They want to be on people.  Put all your attention on the head.

If after 48 hours, live lice are still seen, and "if steps were missed or hair products with conditioner were used...repeat the treatment with the same product immediately..."
Permethrin is a pesticide.  And there are many studies to show it is no longer effective.  It just doesn't work.

This pamphlet implies that if you do a proper second treatment in a week, then you will have solved your problem. The steps end with the phrase, "That's it - you're done!"
Are you kidding me? The huge majority of my business comes from people who have tried these "shampoos" 2, 3, 4, or more times! They've followed every direction, cleaned every surface, and gone mad because the lice remained a problem.

"Hair dryers, hair conditioners, vinegar rinses and chlorinated swimming pools should be avoided for 7-10 days..."
Hair dryers and hair conditioners can actually have a place in the fight against head lice. I discuss the topic of hair dryers in this post. For my post on hair conditioners, click here.

This pamphlet has a some good advice, but its emphasis on the use of lice "shampoos" is part of what I believe is causing so many cases of head lice in our schools. In step #4 of "How to Treat", it tells you to remove the eggs, but it doesn't really explain just how time consuming or how absolutely essential this step is. It doesn't tell you that you will have to manually remove the bugs as well. In my mind, you could get rid of almost every step in this pamphlet except step #4, and then you should have it repeated again and again.

One more note. If a doctor or a health nurse tells you that you have head lice, but then a lice removal professional comes over and says that you don't, trust the lice removal professional. I was once called in to see a woman to offer a third opinion. This woman had seen her doctor who told her that she definitely had head lice (even though he barely looked at her head). Then she had called another lice removal professional to remove the lice, and was told that she didn't have head lice. Then the woman called me and I told her that she could probably trust the other lice removal professional, but she wanted me to come in anyway. I went to see her and found that she didn't have head lice. Unfortunately, she still believed her doctor and called me a week later to check again. She still didn't have head lice, but she did have an itchy scalp from the useless half-dozen treatments she had given herself in the meantime.

Another good website...

Another good website with sound research about head lice infestations has been developed by The Journal of Paediatrics and Child Health and you can see it here. While this site seems to promote the use of pesticidal treatments (which I do not recommend), it also mentions some of the research that shows that lice have become resistant to these treatments in some countries (there is no Canadian research, but our situation is similar to the United States). It also mentions that many of these treatments can be toxic in certain situations.

I like that this site is that it discusses the idea that you can have nits but NO infestation. I hope you will read about this and realize that you don't need to reach for a bottle of pesticide every time you see an egg. I also like that this site says that going into an super-insane cleaning frenzy is unnecessary. (OK, I may have paraphrased that, but the idea is the same.)

What I don't like about this site? It says that wet combing has not been proven effective in the fight against head lice, but there is another study that says it has (and you can see it here.) All in all, this site has some good information. Remember though, in my book, no lice shampoo is good lice shampoo. You would do better (and be richer) if you would just take the time to pick/comb everything out.

What if you can't pick or comb...an oldie but a goodie.

I once wrote a blog post entitiled "What if you can't pick or comb". I think it has some good information. Check it out here.

When others have head lice.

So your cousin has head lice. Should you let her come for a visit? You find out that 3 kids in your child's classroom are totally infested. Should you keep your child home or should you raise a stink with the principal? The mother of your son's best friend just called - her kid has head lice. Do you keep the boys apart?

When someone with lice is coming for a visit, don't isolate yourself - just take some simple precautions. If you or your children have long hair, pull the hair up in a ponytail. If the visitor has long hair, ask him/her to pull it up (this is easier to do when your guests are children). Address the issue with your guest at the start of the visit. If your guest is staying over, give him/her fresh bedding and wash and dry the bedding in high heat each day. Put towels over the tops or arms of the couches - anywhere where someone might lay their head. Put your brushes and combs away. Make sure no one shares hats or hair accessories. Set some ground rules about contact - no hugging when possible (But hey, if my friend was really upset, she might need a hug, and I'd give her one, head lice or no head lice.) And then do regular head lice checks on yourself and members of your household.

With regards to the lice in your child's classroom, talk to the other parents, or talk to the teacher to make sure that everyone is aware of the problem. Offer information and support. And by all means, give them my number!

Have a nice lice frame of mind without going buggy.

When you discover that you or someone you care about has head lice, you know that you are in for some work. You are discouraged because this little "surprise" upsets your family, your schedule, and maybe even your budget (it doesn't have to - don't buy the shampoos!).

However, there is something that is much more exhausting than dealing with head lice: it is the paranoia that some people create around the head lice. Hours of reading about head lice on the Internet. Days and days of cleaning, shampooing, and washing. Constantly monitoring the comings and goings of everyone in the household. Thinking every little itch must be a bug bite. This flurry of agitated activity is absolutely exhausting, not to mention absolutely unnecessary. THIS IS JUST HEAD LICE! Calm down. You will need to do some work to get rid of it - conserve your energies for more productive behaviours.
While paranoia is not productive, the same can be said of an attitude that is too relaxed. I hear people say, "Oh, head lice is just a part of life and you can never really get rid of it.", or, "What's the point of wasting time picking out the lice when my son is just going to come home from school with another case of it next week?" It is attitudes like these which have led to the head lice epidemic that we have in our schools. Having head lice is not in and of itself a health issue, but it is a very real social problem and can leave you or your child feeling like a outcast. And then there's the maddening itching, which leads to scratching, and the scratching can lead to wounds. (If these get infected, then you ARE dealing with a health problem). Choosing to do nothing, or choosing to do very little (i.e. using "shampoos" that don't really work) passes your problem on to others as well.

Stop the paranoia, but don't be ignorant. Don't freak out about head lice, but be prepared to really deal with it. Be diligent, and patient. Lighten up, but don't tune out. Have a nice lice frame of mind.

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.

Jeopardy Question: These parasitic insects live only on the human scalp.

Answer: What are head lice? (Pediculosis Capitis)
For more general info about lice and nits - what they are like and what to do with them when you find them - check out the my blog posts from November 2008.

Another note: See this picture. See the little red baby louse? (It is red because it just ate.) On your head, that nymph is about the size of a speck of pepper and you usually can't see the outline of its legs with the naked eye unless it is in front of a completely white background. (Because of the age and the size of these little red guys, my daughter calls them "Baby Spice".) So, if you are doing your own lice removal, and you see a tiny speck on the head, don't waste your time wondering if it is lice. Just remove it. When in doubt, take it out.

Working the bugs out of the new school year.

Though I am a life-long learner, I am not currently in school. Still, September always makes me sentimental - it is a transition between the carefree days of summer and the buzz of "back to school". If you are getting your children ready for the "new year", don't forget to check them and prep them. In other words, do a thorough check for head lice before sending them back into the classroom and teach them how lice spread - head to head contact. Make sure you incorporate regular lice checks (through wet combing) into your weekly routine because by the time a family realizes they have head lice they may already have had it for 3 months. Regular checks find lice before the itching even begins.  Your kids should be itching to get back to school but not itching once they get there.