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.

Have a question? It might already be answered...

This is a small request from me to anyone who wants to contact me regarding their head lice struggles.  Please read a number of my blog posts before you contact me.  Most of the questions I receive have been answered in past blog posts.  When someone writes to me and says, "I love your blog! I've read every post!  I have a question...when can I stop washing all my bedding every day?", then I know that this person has not read much of my blog because I have said time and time again that doing any extra cleaning/laundering is a waste of time.  Many "experts" in different fields have very simple messages and techniques.  In the area of parenting, the Supernanny promotes the "naughty spot", positive reinforcement, and consistency. In finance,  Gail Vaz Oxlade promotes techniques such as using cash only, developing a realistic budget, writing down every purchase, and communicating with your partner.  My message in the field of head lice prevention and removal is also simple and can be summed up in a few points. 

So, if you have read this blog, here are the highlights:

1. Don't waste any extra time or energy doing cleaning or laundering.
You don't have to wash the bedding or clothes (including hats), vacuum the rugs or the furniture, pack away the toys or stuffed animals.  Clean your home as you would in your regular routine.  Lice will not survive off of the head.

2. Don't waste your time and money on ineffective quick fixes.
I don't recommend any "shampoos" or "treatments"with the exception of some excellent metal lice combs.  The solution to the problem of head lice should never cause financial hardship. 

3.  Do commit time and energy to what's on the head.
A thorough wet combing ever 2-3 days until 2 weeks have gone by with no evidence of head lice is a system that works.  Make sure you have a proper metal lice comb.

4. Talk to others and educate them about what really works.
I find it hard to believe that in a world where sex is on almost every billboard and violent shows are on TV at all times of the day, that the topic of head lice still brings shame.  This shame is based in a misunderstanding of the problem.  Read the research (there are links on this blog).  Get equipped and start talking with others.  Become the lice lady/man in your area.

Of course, there are more details to be found within each of these simple messages.  Normally, I would link these points to other posts that support their message, but this time I want you go on a treasure hunt.  Click around the blog and look at past posts.  Once you've read the info, if you still haven't had your questions answered, feel free to leave your question in the comments section of any post.  I will be happy to answer.

Thoughts on Tea Tree Oil

Let me start this post by saying I don't recommend, endorse, or even use any special lice shampoos or treatments.  If you've read this blog before, you know this.  However, you also know I'll let you know about lice research.  And one of the questions I get asked about most is tea tree oil. 

For years, I've looked, but never found any strong research on tea tree oil in relation to head lice.  But today I found the synopsis of a 2010 study done at the University of Queensland.    Follow the link to see the abstract. The catchy title says it all: "A randomised, assessor blind, parallel group comparative efficacy trial of three products for the treatment of head lice in children--melaleuca oil and lavender oil, pyrethrins and piperonyl butoxide, and a "suffocation" product."

This study seems to demonstrate that a shampoo with tea tree oil AND lavender oil has effectiveness against head lice.  Before you go out and buy a bunch of essential oils, please consider these points:

1. Just because something is seen as "natural", it doesn't guarantee safety.
The American National Institutes of Health offers these cautions about tea tree oil:

• Tea tree oil contains varying amounts of 1,8–cineole, a skin irritant. Products with high amounts of this compound may cause skin irritation or contact dermatitis, an allergic reaction, in some individuals. Oxidized tea tree oil (oil that has been exposed to air) may trigger allergies more than fresh tea tree oil.
• Tea tree oil should not be swallowed. Poisonings, mainly in children, have caused drowsiness, disorientation, rash, and ataxia—a loss of muscle control in the arms and legs causing a lack of balance and coordination. One patient went into a coma after drinking half a cup of tea tree oil.
• Topical use of diluted tea tree oil is generally considered safe for most adults. However, one case study did report a young boy who had developed breast growth after using a styling gel and shampoo that contained both lavender oil and tea tree oil.
• Tell all your health care providers about any complementary health practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

And the University of Maryland Medical Centre says this about lavender oil:

• A small study published in the New England Journal of Medicine in 2007 concluded that lavender and tea oils in some shampoos, soaps, and lotions may cause gynecomastia, breast development in a male, in boys. 
•  Lavender oil is toxic if taken orally.
• There are no known scientific reports of interactions between lavender and conventional medications. However, because lavender promotes relaxation, it may make the effects of central nervous depressants stronger.

2. Effective once doesn't mean effective always.

It is now common knowledge around lice circles (though seemingly not common knowledge with our local school systems and public health authorities) that permethrin/pyrethrin based products, like Nix, have lost their effectiveness.  There are other products that are also losing their effectiveness and tea tree oil has also lost effectiveness in some parts of the world.  Lice researcher, Ian Burgess says, "‘Tea tree oil has a component that works in the same way as the insecticide malathion, so lice are also resistant to it.’  My own anecdotal offering is that I have been to many, many homes where people have tried a variety of products that include tea tree oil with no success. 

When trying to get rid of head lice, we often grasp for any miracle cure, and if that cure seems natural, then we often buy into it hook, line, and sinker.  You know my thoughts about this.  If you choose to use any "shampoo", you will still need to do manual lice and nit removal.  But manual removal, done with a proper comb on wet, conditioned hair is also proven to be very effective.  And it is much cheaper.  You know my vote.  Skip the tea tree oil.

Lice Picking and Ergonomics (Spoiler Alert: Don't forget to stretch.)

If you read this blog, you know that I have taken a break from lice and nit picking.  First, it was for family reasons.  Now, it's because I have a neck problem that gives me arm pain.  The cause of this problem is unknown, but I'm sure that my bad posture in my work didn't help the situation.

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.