What You Should Know About Head Lice

Here are some basic facts about head lice. You should really know what you are dealing with. As they say, knowledge is power.

Head lice are very small, and often difficult to find on the scalp, but they are not microscopic.
Lice and eggs are not like viruses - they can be seen with the naked eye. Their eggs are like tiny oval drops that are yellowish-white and are completely glued to the hair. The baby louse starts out as small as a speck of pepper. After hatching, it is completely clear in colour, but it turns red after its first meal, and it then turns a translucent brownish colour as it grows. Its colour can also be enhanced by the colour of the hair it is in – head lice look darker in lighter hair and can easily blend in with darker hair. A louse is as big as a sesame seed when it is fully grown.

The life cycle of lice lasts around 50 days.
They are in an egg for 7-10 days. After they hatch, they grow and molt their way to adulthood for another 10 days or so, and then once they reach adulthood, they live for about 30 days.

The female louse can lay about 3-10 eggs every day.
She can lay up to about 100 eggs in her lifetime. It sounds like a lot, but you can always pick her eggs off faster than she can lay them if you are diligent.

Lice are only passed from head to head through direct contact.
They cannot jump, they cannot fly, and you can’t get them just by being a room with someone who had head lice. The most current research shows that you also cannot get them from inanimate objects such as hats or brushes that have been used by someone who has head lice.

Head lice are a nuisance and a big inconvenience, but they are not a health issue. Unless you scratch your head so much that you create wounds that get infected, the head lice just create a bothersome itch, and that’s all.

Head lice like clean heads. They like dirty heads. They just like heads.
Having head lice does not mean that you have poor hygiene.

Head lice can only survive off the head for 2-3 days.
Otherwise, they starve.

Head lice can hold their breath and hang on.
This is why they are not affected when you go swimming or have a shower.

Head lice live on the human head (and sometimes they visit the neck for a snack).
You cannot give them to or get them from your pets. If you see bites on other parts of your body, you are dealing with something else and should seek medical attention. If you see bugs crawling around your home and you know that they didn’t just get shaken or brushed off of your head, then you can safely say that they aren’t head lice but a different problem to deal with.

Head lice are stopped by head cleaning, not house cleaning.There is no evidence to show that house cleaning or laundering will reduce your chances of reinfestation or will increase your chances of getting rid of the problem. They live on the head and are useless off of the head. So don't waste your energy by performing a marathon cleaning/laundry frenzy. Save your time for dealing with what's on the head.

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.

Study says wet combing is more effective than "treatments".

Here is a link to an article that reported on a study about wet combing. In this study, wet combing was proven to be more effective than over-the-counter treatments:

http://news.bbc.co.uk/2/hi/health/4744929.stm

Isn't that just what I've been saying, my dears? Adult lice go into survival mode when wet - they "freeze", staying still long enough for you to comb many of them out. (Note that I'm talking about ADULT bugs - baby bugs, or nymphs, are often too tiny, so keep combing regularly until you are sure the problem is gone.) When you wet comb, add a little bit of conditioner to the hair to keep it from drying too quickly. Also, don't forget to remove the eggs as well (the combs, even the excellent combs, won't remove all the nits). One thing I find interesting though - this article mentions a product called "The Bug Buster Kit". Do you know what this kit is? A box of fine-tooth combs. Even a regular comb can take out a quite a few adult bugs when the hair is wet. Why do we have to make combing into a "program" or "product"? Yet another gimmick to buy. But there is no product that will completely get rid of head lice.

But there is a person that can get rid of head lice - YOU. (And if you want some help, just call me.)

Everyone wants the magic pill.

The Edmonton Journal ran an article in today's paper from the Los Angeles Times. This article was about a drug that could be taken in pill form that would get rid of head lice.

This pill is nothing new under the lice-fighting sun. The drug is an anti-parasitic drug called Ivermectin. It has been used for years with livestock, but is not approved for human use in North America. When I saw the Journal's headline, "Pill may be a better parasite killer", I was saddened. How long are we going to look for the magic pill in getting rid of head lice? As with any oral medication, ivermectin can have side effects, some of which are worse than the itching of head lice. The study presented in this article was not just a study on ivermectin alone - it showed that malathion lotion (another topical pesticide) was more effective in killing head lice when paired with ivermectin pills. However, let me highlight a few parts of this article:

In the article, Dr. Olivier Chosidow says that, as with the over-the-counter products, "lice can become resistant to ivermectin". He also is quoted as saying that the medicine can cause problems for some people. The article then lists the side effects experienced by some people in the study.

My favourite quote from the article is from Dr. Barbara Frankowski from the University of Vermont College of Medicine. She says, "In the grand scheme of what kids get, head lice is minimal. It get blown out of proportion. For me to want to use something on a patient, it has to be 100% safe. You never want the cure to be worse than the problem you're trying to get rid of." Very true, and the only thing that is both effective and completely safe is picking/combing.

Time is on your side.

Nit-picking is the most effective way to get rid of your head-lice problem. So, why are people so reluctant to do it? You might think that a lot of people are really grossed out by the bugs. But, for most people, that's not the issue. They don't want to get down to the business of nit-picking because they feel "they just don't have the time".

Yes, nitpicking takes time. It can an hour or two, or even longer if you do it all at once. But if you think that there is any treatment that can speed up the process for you, then you are very mistaken. The "shampoos" will not kill all the bugs and will not kill the eggs. You will have to use more time and more money dealing with the problem again in a matter of days. And, as you know if you have ever used the so-called treatments, their instructions state that you still have to pick out all eggs and bugs. So, you see, absolutely no time is saved by using a commercial treatment.

The good news is, you don't have to have a 5 hour marathon nit-picking session that causes your hands to cramp up and your eyes to blur. An adult louse only lays 3-10 eggs in a day - that may seem like a lot, but you can pick faster than that. So, if you can't deal with your family member's head lice problem in one or two longer sittings, here's what I suggest. Pick for as long as you can over a number of days. Even 15 minutes here and 20 minutes there every day will get you ahead of the game. Your priority is to pick out any bugs that you see. Then grab the eggs as you can. A real lice comb will speed things up even more. Be sure to keep things relatively clean , take basic precautions so that other people in the house don't also get head lice, and do regular quick head checks on everybody and you will be fine. If you keep doing this, then there will come a day very soon when you will no longer see any bugs or eggs.

You can call me for more free info. And if you want to have me come over to pick, I will gladly take your money. But it probably isn't necessary. You can always find the time to deal with this. Just do it.

Outbreak, Epidemic, and other nonsense words.

Yesterday someone told me that their son's school had an outbreak of head lice. An outbreak? Wasn't "Outbreak" that movie with Dustin Hoffman where he was dealing with a deadly airborne virus? That word, as well as the word "epidemic" can cause a lot of unnecessary panic. Head lice is a year round concern in schools. But once it we realize it might affect us, it becomes an outbreak. And the head lice treatment companies want you to think of head lice as an epidemic - your panic brings in big profits.

The louse is not a virus. While it often blends in with the colour of the hair, it is visible without a magnifying glass or microscope (if you can read small print, you can see head lice and eggs). It is not an airborne creature - it does not jump from head to head, nor can you get it by just being in the same room as someone with head lice. And pesticidal "shampoos" will not get rid of the problem.

Read more about head lice here. Read more here about how to get rid of head lice. If you have questions about head lice, just call me. You don't have to use my services, just call me. It is time to stop panicking.

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.