Comment of the Day: Lice in African-American Hair

Here's a comment I just received:

"Hello, I am African American and my 5year old got head lice from school. I have found it very difficult to use the combing method because of her natural hair is very kinky and curly when wet. It just seems to pull out the hair and it is painful for her. Myself and my 2 year old also have lice now. I used the shampoo I used lots of hair grease I see a few nits but they fall off easily. There is not much info on lice and African American hair. What do you recommend? I do not see live lice just a few tiny nits. How often should I wash bedding? What color are live lice?"

Hmm. There's not much info about lice in African-American hair because it is not commonly seen in African-American hair due to the shape of the hair shaft. (See an earlier post about this here.)There are those that say that African-American people don't get lice, which is not true. Cases are uncommon, but lice are very good at adapting and I am sure that we will just see more and more cases of lice in this population.

In your case, are you sure you actually have head lice? You say you haven't seen any live lice and the what you think have been nits have fallen off easily, which doesn't really happen. Nits are glued to the hair and have to be scraped off the hair shaft with a good lice comb or with your fingernails, so if something is coming off with just a flick or a light rub, I would guess that it is just dandruff. Also, you really need to see a louse before you can be certain you have an active case of head lice. Lice are small but not microscopic (though I really enjoy putting them under a microscope!) They are usually a mousy brown colour but can look darker in light hair and lighter in dark hair but are also sort of translucent and can blend in with many hair colours (which is a pain).

But let's assume you are dealing with head lice. So what to do? It truly is more difficult to get a good lice comb through very curly and coarse hair. However, I have done it by wetting the hair and using almost an entire bottle of the cheapest hair conditioner on one head when combing - you may not need to do this, just use as much as you need. You don't rinse this out, you comb through it. This can help to make the hair straighter and detangled for combing. (You first need to detangle with a brush or a wide-toothed comb before you start with a lice comb.) Unfortunately, combing through tight curly hair is more time consuming, quite messy (I recommend you climb in the bathtub with your own kids for lice combing when you need loads of conditioner - the water and bath toys help keep them occupied). It becomes more difficult to see what you have combed off the scalp when you are combing off globs of hair conditioner, but it can be done.  After combing, wipe your comb on some toilet paper and look through the conditioner for signs of eggs or bugs.You may need to try out different metal lice combs to find one that works for you that doesn't pull out your hair. Do not comb the hair unless it is wet and coated with conditioner. Hair conditioner is better to use than other greasy products like olive oil because the grease can actually grab at the comb, where the hair conditioner will allow for a smoother and more continuous stroke from root to tip.

Even if the combing is tough, keep trying. If you have tried different metal combs and have been doing wet combing with conditioner and you still find it too hard, then you can try wet combing with a plastic fine toothed comb. Plastic combs generally do nothing in the way of removing nits and very little to remove nymphs, but they can still remove many larger bugs through wet combing with conditioner. And if you can't comb out everything, it is still better to comb out something. If you keep combing thoroughly and regularly (every couple of days), the idea is that you will be able to comb out the bugs as they hatch but hopefully before they can lay new eggs allowing you to outrun the problem. As for nits, if the metal lice comb is too painful, get yourself in good light (I recommend using a cheap head lamp for nit-picking) and pick out anything you can see.  Focus mostly on anything you see right next to the scalp. And, if you are not sure about what you are seeing, when in doubt, pick it out.

Lastly, read about the use of an ordinary hair dryer as a lice-fighting tool in other posts on this blog. There is research to show that fast-blowing warm (not hot) directed air blown on sections of the hair and scalp can dry out most of the nits and about half of the bugs. Use the blow dryer on dry hair on the highest speed, but don't burn your children with the highest heat. I like the use of a blow dryer because, like a good lice comb, it is a tool you can use again and again. Read the posts for more info and check out the research.

As for lice shampoos, I personally don't recommend them but only because of their limited (or non-existent) effectiveness, the false sense of security that they give,  and their extra cost. As for house cleaning and laundering, I DO NOT RECOMMEND that you do any extra cleaning. There is no research to show that this helps in any way and research to show that it has no effect (again, check out the research links on the blog).  I have much experience to show that parents who focus on the surroundings more than on the scalps burn themselves out and make themselves nuts over these ineffective, busy, and costly tasks.  Keep your focus on the head. You've got enough to do with the combing, picking, and blowing. Try to maintain some balance, keep things in perspective, get some sleep, and stick with it  until you have had 2 weeks with no new sightings.

Good luck!

Head Lice Prevention: Is There Such a Thing?

When I talk with families that have gone through a cycle of head lice in the home, they always want to know what they can do to keep it from happening again.  Questions like, "Should I shampoo with tea-tree oil?"  "Should I spray my furniture?" "Should I ban my child from having sleepovers?"

I think people should forget about "treatments" for head lice prevention.  Claims about various natural repellents have not been sufficiently proven as effective or even safe and they are certainly not regulated. In my travels, I have seen many a case of head lice where the family used rinses and sprays as prevention but still found themselves with active cases of head lice. These so-called preventative treatments are costly.  Spending tons of money, changing our household routines in significant ways, or limiting the activities of our children only gives more power to the head lice paranoia and does little or nothing to actually protect us.

What do I do with my own family to keep head lice at bay?  Once a week, my kids and I

Hire a professional or don't. Either way, you still gotta put in some time.

Here's a question I just received:

"My friend said she had lice but she got treated two weeks ago. She said that the first time you get treated at places like (insert lice removal salon here), you cannot give lice to someone else. You can't spread. Is this true?"

Here's my answer:

The answer to this is not so cut and dry. If someone is known to have had head lice, I generally assume that they still have it until there have been no sightings of new lice or nits for two weeks. However, just because a person may still have head lice, it doesn't mean that they are necessarily able to spread it. A lice professional will usually be able to remove all adult bugs in the first sitting. It is the adult bug that can leave the head - newly hatched nymphs will not venture off the head for at least a week. So, a person with head lice may be of no immediate threat to others (which is one reason I'm against no-nit policies in schools and day care centres). But let's say that a tiny nymph was missed by the lice professional.  In 7-10 days, if no further combing had been done, there would be a new adult louse on the head that would be able to transfer to someone else through head-to-head contact.

While I generally trust experienced lice professionals (as long as they focus on lice removal over pushing lice "shampoos"), I never underestimate head lice.  I challenge lice professionals who claim to deal completely with your head lice problem in one visit. If they get the bugs out, the chances that they've missed an egg or even a tiny louse,  are still high. When I do home visits, I always offer a free follow up. This is because I believe that everyone should have a second visit with the professional - all of this and I still instruct families to still keep up with their own lice combing. I respect head lice and their resiliency. No matter what "treatment", no matter which professional is utilized, the affected head should still be thoroughly wet combed every couple of days with a good metal lice comb until at least 2 weeks have passed with no new sightings of lice or nits.

Now remember, you don't NEED a lice professional and I really have a problem with professionals that tell people that you must use an expensive product or service in order to deal with lice effectively. I've seen too many hard-working, low-income families who put themselves at risk by throwing away hundreds of dollars and buckets of sanity over their lice problem because of some "expert advice". I've seen people who give up because they feel they will never be able to afford the cost of "treatments" or services.  You know, head lice was dealt with effectively before the invention of salons and chemicals and paid services and fancy tools.  Back in the day, if someone had head lice, you just got in some good light, buckled down, and nitpicked for hours, everyday, until the lice were gone.  Yes, that actually works.

Lice removal professionals are more like housekeepers than health care workers. Everyone can vacuum, but some people don't want to so they hire a cleaner.  Everyone can deal with their own head lice problem, but some people don't want to and that's OK as long as they can truly afford it.  There are times you might want to use the services of a lice professional. (Read my post about this here.) but it isn't a necessity AND using their services won't let you off the hook - you will still have to do lice checking and combing at home.

The lice are on your scalp. Don't let them mess with your mind.

My mother used to have this picture on a sweatshirt.  She was a woman known for her humour, but she was also known for how stressed out she could get. Normally, with life's stressors, we can cope.  Work can stress me out, but I can go home at the end of the day.  If the kids are stressing me out, I can usually find a sitter for a little while.  However, if you have head lice, you don't feel like you can get away from the stress - it's with you day and night, wherever you go,  and since lice problems aren't fixed in a day, you get to feel this stress over time. It can wear you down.

We have to be intentional about how we deal with this stress.  I covered this in the post below , but it so important to remember.  We work hard to get rid of head lice, but we also have to work hard to push past our own panic and fear.  I once met a woman who chose to sleep in her car in the winter thinking that the cold would kill the bugs.  You know, sleeping in freezing temperatures could also kill her!  Step out of your emotions and let your intellect help you assess the real risk of head lice over the perceived risk.

If you don't deal effectively with the head lice, what's the worst that could happen?

• Your head could get really, really itchy.
• You're hair wouldn't look pretty.
• You could pass it to someone else.
• In very rare cases, you can have a greater allergic reaction to head lice. (In the bazillion people I've met with head lice, I've only met one person to have a worse reaction - she had swollen glands and flu-like symptoms. Her doctor told her to take an over-the-counter antihistamine.)

If you go crazy dealing with head lice (spending tons of money, losing sleep, missing school/work, stressing out), what's the worst that could happen?

• You could get very sick - physically and psychologically.
• You could put your financial stability at risk. 
• You could put a strain on your relationships.
• You could lose your job or fall behind in school.

These problems are greater than the problem of having head lice. Head lice cause the first group of calamities.  We cause the rest.   Try to keep head lice in perspective.  Give head lice the attention they deserve, but don't give them one second more.

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...

Time to stop and smell the family. Wait, that didn't come out right...

This is just a quick post to say that I'm taking a break from picking lice and nits in the home.  Just need a little less time with your lice and little more time with my family.  The thing is though, educating people about head lice is my passion.  I'll still be reviewing research and showing you the evidence to check out and the gimmicks to avoid.
 

And, I'm still willing to answer your questions for free (as always), but I'd rather do this via this blog or through my email, thenicelicelady@live.com.

I'll keep you posted on when I'm back in business.  Remember - you don't need a professional or expensive treatments to get rid of head lice.  You just need to be willing to learn, willing to act, and willing to keep going until it's gone.  Read this blog to learn what to do (wet comb with a good lice comb and focus all energy on the head) and what not to do (frantically clean the house and spend hundreds of dollars on ineffective treatments.) 

As I always say, you can outrun head lice.  And feel free to drop me a line. You can do this.

Liceworld. Not Disneyland but still exciting for me!

In the effort to always give you the most up-to-date about head lice information, I want to show everyone a great website called "Liceworld".  I just found it and the information is great.  Lice researcher Ian Burgess is one of the contributors. From what I see now,  it seems this website has been created for the purpose of providing information.  However, most researchers (Ian Burgess included) have links to some type of product so I suspect that in the near future, we will see some links to some money-makers (It's the development part of R&D - research and development - that really pays the bills.)  Still, so far, it looks good. Check it out here.

Faster, higher, stronger

Here's a link to an article from the British newspaper, The Telegraph, where it says that a extra humid conditions led to an increase in the number of cases of head lice just before the Olympics.  The article quotes Ian Burgess, one of my favourite lice researchers, as saying one in ten children has head lice. It also says that over half of Britain's 4 to 11 year olds get lice every year. It mentions that 53% of people are asymptomatic (they don't know they have lice until the problem is really bad) and that lice are immune to over the counter products 80% of the time.  Interesting stats - I wish they would show the research to back this. Interesting that this increase happened just before the Olympics. These lice fit the motto of "faster, higher, stronger".

Loose ends...

Here are two quick tips that I've been meaning to share.  They don't come from me, but they are very good to know...

1. If you or someone you know has head lice AND a problem with dandruff, deal with the dandruff first. Use a good dandruff shampoo and try to get out all the flakes. This will save you from trying to determine if what you are seeing is lice or dandruff. (Thanks to the mother - I'm sorry I lost your name - who gave me this tip a few months ago.  Great idea.)

2. Here's a tip that is important to know if you are using the inexpensive purple lice comb that I recommend on this blog.  I have had 3 calls in the last two months where people have told me that on their purple combs, the side with the short teeth pulls through the hair and tears some of it out.  This is surprising to me as I have purchased many of these combs over the years and have never experienced this.  Still, when I hear this news from 3 different sources, I tend to believe it. Maybe it's a bad batch?  These callers still used the purple comb and found that it worked well - they just stopped using the side with the short teeth. 

Got any more tips?

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.