Siblings and Head Lice: Tips

April 10 is National Siblings Day, and we are using the day to call attention to the fact that siblings are often the channel used by head lice to spread.

“The closer in age siblings are, the more likely it is for them to spread lice to one another.”  “That’s because they are likely to spend more time together and share rooms, hair accessories, and clothing that might carry hair with lice.”

According to a study of Norwegian school children, an infested sibling increases the odds of a child contracting head lice by 36 percent. In some school districts, if a student is found to have head lice, any siblings at the school are also checked.

Lice spread primarily through head-to-head contact. When siblings share a bed or bedroom, and one has head lice, others are likely to get lice, too. Lice don’t fly or jump, but if a louse is on a shaft of hair that falls on a jacket or hat or hair brush, it will crawl onto the next head it can find in a matter of seconds.

“Lice can’t live anywhere but on a human head,” Desmond said. “It is a matter of survival to get on the nearest head.”

Lice can be aggravating, but you can work your way through this nuisance. Here's How:

It’s the time of year when kids gather in school. They’re building friendships, sharing curiosity and… yep, sometimes swapping head lice. It can happen in any school with any kids. Personal hygiene and home or school cleanliness has nothing to do with head lice or their spread.

If you have children, you may already be familiar with head lice. Head lice infestations are common in pre-schools and elementary schools. They can spread around to everyone in a household, regardless of age.

 Getting Acquainted with… Head Lice

Head lice are small parasitic insects. They live on the scalp. They like the areas behind and around ears and near the neckline at the back of the head. Sometimes they can be in the eyelashes or eyebrows, but that’s uncommon.

Lice start as eggs, or nits, that are tiny. Nymphs hatch from eggs. Nymphs look like a small version of the adult. The adult louse (singular for lice) is about the size of a sesame seed. It has six legs and is tan to light gray.

Females are bigger than the males and can lay about six eggs every day. An adult louse can live up to 30 days on a person. They live only a couple of days when not on a person. Lice feed on human blood to live. 

How Do Head Lice Get Around?

These bugs cannot hop or fly. They typically crawl from person to person when head-to-head contact is made. It’s less common but they can also move from person to person when clothing, hats, scarves, combs, brushes, towels or plush toys are shared. 

What Are the Signs of Head Lice?

The Centers for Disease Control and Prevention (CDC) says a person with head lice may notice:

• A tickling feeling of something moving in the hair. That happens because there is something moving in the hair. (You’re right, that’s a little gross.) 

• Itching. This can be caused by an allergic reaction to a louse bite.

• Irritability and trouble sleeping. This can happen because head lice are most active in the dark. 

• Sores on the head caused by scratching. The sores can become infected by bacteria found on the skin. (Saying “ewwwww” now would be totally understandable.)

OK, Let’s Bring Up Some Good News

The good news is: Head lice are not considered a medical or public health hazard by the CDC. And they are not known to spread disease. 

Dogs, cats and other pets do not seem to help spread head lice. That’s another reason to love your pet. 

For the most part, head lice are spread by simple contact between people. If you can avoid close contact, you can reduce the risk of spreading the little pests.

Cases of shared sports helmets spreading head lice are rare. The feet of head lice are adapted to hang onto hair, but they tend to fall off surfaces such as plastic, metal, polished synthetic leathers and such.

Prevent Re-infestations

Immediately after treatment, the person you’ve treated should put on clean clothing.

Gather items such as hats, scarves, pillowcases, bedding, clothing and towels used by people with lice. Gather things they used in the two days before treatment. 

Wash the items in water 130 degrees or warmer. The items should be in the water at least five minutes. Then dry on a hot air cycle. 

If an item can’t be laundered, it can be dry cleaned or sealed in a plastic bag for two weeks. 

Soak combs and hairbrushes in water that’s at least 130 degrees for five to 10 minutes. 

Vacuum furniture and floors. This can pick up hairs that may have nits attached. 

There… that’s probably all you’d ever want to know about head lice. Oh, there’s one more thing.

Other Types of Lice

Along with head lice, there’s also:

• Pubic lice. Also called crabs. They’re found in the pubic area, and sometimes on eyelashes, eyebrows, under arms and on chest hair. They’re rarely found on the scalp.

• Body lice. They live and lay their eggs (nits) in clothing seams. They crawl to the body to feed. 

Listerine Lice Treatment: Why It Doesn't Work

The Rundown

First of all, don’t use Listerine as a treatment for lice. Just don’t. It may be an appealing alternative due to its price when compared to the price of lice shampoos and treatments, but that’s because it’s not a lice shampoo.

To be classified as a lice treatment, products must go through extensive testing by the FDA and other regulatory agencies, submitted in clinical trials, and proven to be consistently effective. Listerine has not done that. It is a mouthwash, not a lice shampoo.

The Ingredients

Listerine
Active Ingredients: Alcohol (30%)
Other ingredients: Eucalyptol, Thymol, Menthol, Methyl Salicylate

Suffocation vs. Dehydration

The reason Listerine doesn’t work to eliminate lice is that different chemicals treat lice differently. The active ingredient in Listerine is alcohol, and alcohol-based alternative lice treatments (like Listerine) predominantly rely on suffocation to eliminate lice. This is a good step, but far from an effective, permanent solution.

Head lice in the egg stage have a protective, waxy coating that acts as a waterproofing agent and allows them to continue their evolution into live nits. (While Listerine may loosen some of the eggs, it’s not enough.) The alcohol in Listerine deprives the eggs of oxygen in order to suffocate them; however, it can take 8-24 hours for suffocation to occur. In that time, the lice eggs can lie dormant and the Listerine wears off. As a result, the affected party will need almost constant Listerine treatments over the course of several days to ensure the lice eggs don’t hatch. In addition, any live nits and eggs will still have to be combed out with a special lice comb.

Method

Why, then, do some people swear by Listerine? The secret may be more in the act than in the ingredients. Many articles that identify this particular method as a solution also call for the use of a lice comb and vinegar. It is more likely the act of combing out the lice with a lice comb, combined with the vinegar, that eliminates the lice more than the active ingredients in Listerine themselves.

Remember those breakfast cereal commercials on Saturday mornings for Apple Jacks that said “part of this complete breakfast,” then showed the sugary cereal alongside four apples, three bananas, two eggs, and a grapefruit? You got the feeling the cereal wasn’t really the main contributor to the “complete” part of the meal.

When it comes to lice treatment, Listerine is much the same as Apple Jacks. It may work as “part of the complete breakfast,” but it is not the key ingredient, or even beneficial to the lice treatment diet. In much the same way the fruit and veggies end up doing most of the work to make up the complete breakfast for the sugary cereal, the lice comb bears the bulk of the responsibility for delivering results on behalf of the Listerine.

The Many Hidden Costs of Head Lice

Professional lice removal can be expensive, especially when multiple family members in the home are affected. However, procrastination in the form of attempting to rid yourself or your family of lice via home remedies is the single highest cost many families experience.

By the time families reach out to us, they have often already spent hundreds of dollars and have nothing to show for it.

There are many hidden costs to home lice treatment that many families simply don’t think about, and waiting too long to get professional lice treatment can mean spending more than double the typical cost of professional lice removal.

THE POTENTIAL COSTS OF HOME LICE TREATMENT

Dry Cleaning: $$

Lice co-pollinate up to 90% of the time in any given household; however, they are unable to live for more than 24 hours in the environment outside of a scalp. In other words, they cannot easily spread from the scalp to clothes, furniture, or other household accessories.

Not knowing this, we often see families rack up huge bills for dry cleaning in an attempt to eradicate what they thought was a house-wide infestation!

As we say, “don’t burn your house down” just because you find lice; simply doing the laundry with an all-natural detergent will do the trick.

Over-the-Counter or Home Treatments: $$

Put simply, these do not work!

New strains of “super lice” have built a resistance to traditional over-the-counter treatments. Applying Nix or any similar product to the scalp and hoping for the best is not going to solve the problem; in fact, it may make things worse by providing a short-lived, false sense of security that ultimately results in reoccurrence and the spreading of lice to others.

Nannies & Sitters: $$$

Want to know what is really great about head lice?

It always happens on a day when your schedule is completely free, with no obligations or responsibilities!

Ha!

Actually, head lice are one of the top three reasons kids miss school each year.

When receiving a call from school or daycare demanding to “pick up your child immediately,” many parents are caught completely off guard and wind up having to hire a nanny or babysitter to pick up and watch their child for the remainder of the day.

Even if lucky enough to find someone in the spur of the moment, costs accrue quickly. Hundreds of dollars, even! Couple that with failed home remedies and what was originally a one-day ordeal quickly turns into two, three or more.

Cha-ching!

Buying New Stuff: $$$

Upon discovering lice, you may have an urge to throw away every sheet, towel, and pillow throughout the household in an effort to eradicate lice. You are not alone! We have spoken with hundreds of families over the years who have thrown away perfectly good sheets, towels, pillows, rugs, and even furniture!

The best advice we can give is don’t panic! (And don’t throw away perfectly good household items.) Call Larger Than Lice and we can walk you through the process of getting rid of lice and nits without moving everything to the curbside bin.

Missed Work: $$$$

Can’t find a sitter? Family and friends not particularly thrilled about the prospect of looking over your lice-infested child while you head off to work?

Sounds like a missed day at the office!

Those of us with school-aged children know how hard it is to balance teacher planning days, holidays, sick days, and inconsistent school schedules with busy work schedules. It requires a lot of understanding by the boss and your fellow coworkers. For that reason, unplanned days off due to a lice outbreak can be especially stressful for working parents. Not to mention the lost pay or vacation days spent staying home.

SPECIAL REPORT: Stopping the cycle of head lice

Many parents worry that their children will get head lice.  According to the American Academy of Pediatrics, that happens for six to 12 million children a year.

Stephanie Speers kids are part of that statistic.

“I went to braid [my daughter’s] hair, and my stomach just dropped,” Speers said.  She saw lice and their eggs, known as nits.  “I started checking [my sons’] hair, and I was like, okay so it’s apparently a family affair.”

Speers’ daughter had lice once before when she was younger.  She said over-the-counter treatments took weeks to get rid of the bugs and eggs.  Patty Ziegler had a similar experience with her daughter. 

“[Lice] are very contagious and will spread quickly,” said Ziegler.

More and more now, professional grade treatments like Ziegler’s are needed to get rid of lice.

“Most lice are super lice,” explained Karen Sokoloff.

Sokoloff added, many over-the-counter treatments don’t get the nits, and home remedies are ineffective.  “What will happen is they’ll comb out what’s visible, and they’ll leave in the tiny [nits].  They’ll just miss it.”

Many school districts have changed their policies within the last five years after recommendations from the AAP and CDC.  The Madison Metropolitan School District is one of those.

“We’re really trying to make more of a caring policy and a less exclusionary policy,” said Sally Zirbel-Donisch, the health services coordinator at MMSD.

Zirbel-Donisch said students at MMSD are no longer routinely mass screened for lice because research showed that wasn’t stopping the spread.  Also, students do not have to go home immediately if head lice are found.  At their parents’ digression they can stay through the rest of the school day because typically children will have had lice for weeks prior to the discovery.  They are sent home with instructions on how to remove lice and checked the next day.

However, a note is not sent home to all parents when a child has lice in the class, grade or school.  “A lot of times those children are stigmatized and isolated, and children in the class know who those students are, and so we really want to protect a child’s privacy,” said Zirbel-Donisch.

Speers’ kids go to school in Janesville.  The district reports a nit reduction policy, meaning as long as no live bugs are found on a student, they can stay in class even if they have nits.  The full Janesville district policy is available at the end of this article.

Speers said, she would appreciate a note going home to parents if someone else in her children’s grade had lice.  “I think it’s really frustrating. I don’t view contracting lice as anything different than the flu bug or a cold or something like that,” she said.  “I think that they should let parents know, so that they can be on the lookout, catch it early, not let the other kids just pass it… It spreads as fast as a virus.”

While the stigma associated with lice prevents some districts from doing this, many health professionals say the stigma is not true.

“I hate the stigma. It’s so backwards,” said Ziegler.  “It’s those kids with the clean hair and the most friends [who get lice].”

Health professionals say the reason for this is because lice are usually spread in a social hair-to-hair contact situation, and the bugs typically only can attach to clean hair.

“People think that head lice is a sign of poor hygiene, but it’s the opposite,” said Sokoloff.

No matter your school or district policies, health professionals suggest stopping the spread of lice by taking matters into your own hands and preventing future cases.

“That openness, that willingness to say, hey we had a case of lice in our family. Texting, emailing, calling friends and saying, maybe take a look at your child and make sure,” said Ziegler.

“The only way to stop the cycle is for everybody who hangs out together checked and treated,” Sokoloff said.

That’s something Speers said she was quick to take care of, notifying her son’s daycare and parents of her other children’s friends.  After she and her three kids were treated at The Bright Side, they went home lice free.

Janesville School District Head Lice Policy

Live lice – These are live lice that have hatched from the eggs and can be seen in a person’s
hair. They are capable of laying eggs and continuing the life cycle of lice.

Nits – These are the eggs that are found on hair shafts, can be hatched or unhatched. They are
cemented on the hair shaft and are hard to remove. Nits close to the scalp have not hatched. Nits
further away from the scalp (more than 1 inch) have already hatched.

Classroom – This is the specific room that a student with live lice or untreated nits were identified.

Grade level – This is the grade level (i.e. all third grade classrooms) where cases of live lice or
untreated nits were identified.

Unit – This is the two grade levels that share time together at recess/lunch (i.e. 4th and 5th grade, or 2nd
and 3rd grade).

1. At the beginning of each school year, schools will include the introductory letter on head lice in the
   informational packet to parents. This introductory letter informs parents about the district actions
   on head lice and actions parents can take to help manage head lice in the school.

2.  Keep Alert! Be suspicious of students who repeatedly scratch their heads.

3. If a student is found to have live head lice, send the student home to be treated along with the letter.

4. If the student is found to have nits only, contact the parent/guardian. Do not send the student home.
   Send the letter home with the student.

5. All other household members to the identified case, should be checked. Household members should be sent home for treatment if live lice are found. If
   no live lice are found, the student may stay in school.

6. Up to three students that are in the same school as the case person, who may be considered a
   suspect or close contact, should be checked for head lice. Students to consider include:

   • Frequent playmates.

   • Students who recently shared combs, brushes, hats, coats, gym towels and/or equipment,
     helmets, dress up clothing, etc.

   • Students who share the same locker or cubbies. Students who are frequent “huggers”.

7. At the elementary and secondary school level:

   • If no other close contacts are found to have live head lice, the follow up screening can stop.

   • If 2 or more close contact students are found to have live lice or nits, proceed to check the
     students in the classroom(s) of the students found to have head lice.

   • If five or more students in the classroom(s) are found to have live head lice or nits,
     immediately contact the school nurse for further direction.

8. Students sent home for treatment can return to school after completing treatment and changing into
   clean clothes.

9. Upon returning to school, students will be checked for live lice. If no live lice are found, the
   student can return to class. If live lice are found, the student will be sent home with the proper
   letter.

10. Students with nits only and no live lice will be able to return to class. The school district supports a
    reduced nit plan. Students with recurrent cases of head lice shall be encouraged to have the nits
    removed.

11. The following actions are recommended to prevent the spread of head lice at school:

    • Store each student’s hats, coats, jackets in separate lockers or cubbies.

    • Do not have dress-up clothes at school that different students can play with and wear without
      being laundered between students.

    • Teach students not to share clothing, towels, hats, scarves, helmets, combs, hair clips, head
      bands, or other personal grooming articles.

    • Store smocks, gym clothes, etc. in separate lockers or cubbies.

    • For longer hair, braid your child’s hair or have it pulled back in a ponytail.

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.

The Zen of 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.

What Parents Need to Know About Head Lice

When your head starts to itch, what’s the first thing that comes to mind?

Since grade school, many of us have been groomed to think “head lice,” the dreaded term indicating that your head is infected with thousands of little scalp-eating bugs.

Just thinking about an itchy head kind of makes you scratch at your scalp, doesn’t it? While an itchy head often just means that your scalp is dry, head lice is nothing to scoff at. They can spread quickly, infecting dozens of kids at a time. Take, for instance, one school district in Pennsylvania.

Dauphin County rests about an hour and a half outside of Philadelphia and Baltimore. It’s home to Hershey, the land of chocolate and Hersheypark, and it’s also the home of the Harrisburg School District, where a recent “unprecedented” head lice outbreak took place.

In 2017, a handful schools in Harrisburg saw over 250 children get infected with head lice, forcing the closure of one of the schools for two days.

The Fosse School, which caters to kindergarten through fourth grade, closed for a Thursday and Friday because over 140 students came down with head lice. Not only that, but almost 50 percent of the students didn’t attend school the following Monday (due to lice or other reasons).

Soon after, another school —the Downey School, which has kindergarten through eighth graders—reported about 100 cases of head lice. A third school in the district, also serving younger children, reported having about 20 cases of head lice at around the same time

To help address the massive outbreak of head lice within their schools, the district’s public relations coordinator said they were in communication with various health departments in the city and around the state “to better understand the origin and scope of this unprecedented lice outbreak.” And that is often the best prevention to outbreaks of head lice: education of what it is and how to stop it before it can infect dozens of children.

The goal is to get ahead of the problem and make sure kids don’t have to miss a lot of school. But before we get into how to stop the head lice, let’s first look at exactly what head lice are and how many people are affected by them.

Who Gets Head Lice, By The Numbers

Head lice are one of the most common parasite infestations in the United States, especially among children. The CDC reports that anywhere from 6 million to 12 million children between the ages of 3 and 11 get infected with head lice every year. This age range—those in preschool all the way up until late elementary school or early middle school—is the most common age group affected by lice.

When it comes to gender, studies have shown that girls are more likely to suffer from a head lice infestation than boys, though the reasons for this aren’t explicitly stated. (Some believe that girls have more close head-to-head contact than boys, which is the primary cause of transmission.)

A report by the American Academy of Physicians says that “all socioeconomic groups are affected, and infestations are seen throughout the world.” The group also says that hair length and the frequency of shampooing and brushing doesn’t affect the likelihood that someone is infected by head lice.

Despite this, the CDC says that head lice is far less common among African Americans than any other race in America. They note that the most common forms of lice found in America “may have claws that are better adapted for grasping the shape and width of some types of hair but not others.”

While children are the most common population affected by head lice, it’s not impossible for adults to contract head lice. This is because they may be in close proximity to infected children, specifically if they work in daycares, schools, hospitals, and other locations with large populations of children.

As one woman explained when she discovered “a city of lice” living in her hair after having an itchy scalp for months, she found that one of her kids had head lice eggs in his hair. But he actually didn’t give it to her, because it was the other way around. And she believes that she may have gotten it from other adults, too, pointing to her frequent plane trips and being in close proximity to hundreds of adults at a time.

So just because your child has lice and you’ve gotten it under control, that doesn’t mean that you or another older family member can’t contract it or be the root cause of the head lice itself.

Keep Calm

Head lice aren’t known to carry or transfer any disease, but all the itching and scratching they cause can have derivative effects. Various diseases and viruses can enter your bloodstream from under your fingernails and through open wounds caused by the irritation of head lice. Despite this, the CDC says that head lice “are not considered a health hazard,” but rather they are an extreme annoyance to us all.

The whole process of getting lice out of your head may take a long time, and you may have to do whatever process you choose more than once to make sure that all of the lice are gone. Don’t cheat the process. “Do the physical labor of getting this out,” Dr. Raj Bhardwaj, a family physician, said. “It’s really gross and it takes a lot of time and your kids have to be patient and you have to be patient and you have to do it more than once.”

There is no need to be embarrassed by head lice, and letting someone else know of its presence can help save the next person from getting it.