Picture: Jessica Flemming (owner of The Lice Lounge in MN) and Cathy Baran (owner of Lice Spies in WA)

Can you treat a case of head lice in one shot, 100% of the time?  Some companies claim to do so.  Can it be so?

Let’s deconstruct the process a bit, to understand how these critters work.  Twenty years ago, lice were just lice.  They did not don their “super” capes.  They were not yet ordained “super lice.”  Over the counter pesticides were great at treating a case of head lice.  There existed a fast, easy potion to rid oneself from these annoying critters.

Over the years, lice started to build a resistance to the pesticides that were once a reliable treatment option.  A few years ago, scientists researched and concluded that head lice resistance to permethrin and pyrethroids were such that the bugs were almost 100% resistance to these products1.  Thus the term, “super lice” came on the scene.

In response to these failing products, new products and methods emerged.  And some of these come with claims of being “one and done.”

Prescription Medications

Doctors today, have a number of prescription medications to choose from for treating a case of head lice.  Is any one of these products 100% effective at killing live lice and eggs (nits)?  No.

 

Rx Product & Efficacy

Permethrin/  Pyrethroids

  • Lice almost 100% resistant1
  • Linked to abnormal behavior in children, neurotoxin

 

Malathion (Ovide)

  • Can kill some bugs, but does not kill eggs, increased resistance
  • Extremely flammable2 around common household devices, burns, neurotoxin

 

Lindane

  • Can kill some bugs, but does not kill eggs, increased resistance
  • Lindane has been banned in 52 countries worldwide due to toxicity3, but Doctors can still prescribe for head lice and scabies.  Can only be used once in human lifetime.  Extremely toxic, neurotoxin.

 

Ivermectin (Sklice®)

  • 74% on day 154
  • $$ May not be covered by insurance

 

Benzyl Alcohol (Ulesfia®)

  • 75.0-76.2% on day 145
  • $$ May not be covered by insurance

 

Spinosad (Natroba™)

  • 85% after 14 days4
  • $$ May not be covered by insurance

 

75-85% isn’t bad though, right?  In a case of head lice, yes it is.  Check out our blog article: 6 month head lice battle OTC prescription pesticides to see the results of one of our client’s struggle.

If you do not get out every last 2 eggs in the hair, where one is male and one is female, then the whole cycle starts all over again.  A female louse only needs to be impregnated once in her lifetime to lay 5-10 eggs per day.  That’s every day of her adult life.  This translates into each impregnated female louse has the ability to lay upwards of 200 eggs in her lifetime.  In the span of those 14 days that you are waiting to see if these products worked, that represents up to 140 eggs that one female left behind could lay.

One has to consider the risks and cost of multiple applications of using these prescription medications knowing that products are not “one and done”.  If you choose to treat with one of these products, know that multiple applications will be needed and constant rechecking to make sure the infestation is truly gone.

 

Heated Air Devices

The most popular heated air device on the market today is the professional AirAlle® device found at salons/clinics, and the new DIY One Cure Lice Treatment Home Kit, both owned by Lice Clinics of America (parent company: Larada Sciences, Inc).  Prior to being branded AirAlle®, the device was known as the LouseBuster.

During clinical trials, the LouseBuster was 94.8% effective at dehydrating, thus killing, bugs and nits when an experienced person was operating the device.6  This is an impressive result.  However, in the case where someone has let’s say, 100 nits, 5 of those nits left behind could be viable.  Leaving behind one female and one male egg will result in the whole cycle starting again. 

It is worth noting that these devices cannot be used on children under the age of 4, or older people that cannot sense heat.

What is key to using this device is the process to remove every last bit of viable evidence in the hair after using the device.  Using the device alone, is not sufficient.  If removal (usually done by a comb out process) is not done, you run the risk of “getting lice back” in two-three weeks, when in fact, you didn’t complete the full treatment the first go around.

Even with the heated air device lice removal option, one should always follow up with a recheck appointment to verify that the treatment was successful.

 

Head Lice Removal Specialists

Armed with good lice combs and safe, non-toxic products, professional removal specialists rely on complete elimination of all nits and bugs on the head.  The gold standard in the industry is to be trained and certified from the Shepherd Institute7.  This certification is the most rigorous and intensive training that is on the market today.

For us here at Lice Spies, our goal is to achieve 100% eradication with one full treatment.  Most of the time, we meet that goal.  But “we are all humans with human eyeballs”, as Jessica Flemming, owner of The Lice Lounge in White Bear and Duluth, MN often says.

Can we miss something?  Absolutely.  How often do we miss something?  Not often, but the point is, it does happen just like any other option on the market.  No product, tool, device or human is perfect!

 

Conclusion

What is common to all the products, devices and methods listed above, is the fact that removing every last viable female and male egg from the head is key to a successful treatment.  Some products can help get you to an effective treatment quicker than others, and they are safe for all to use.  Other products come with the risk of some serious side effects that in our opinion, are just not worth it.

No product, tool, device or human has a 100% efficacy rate.  For this reason, we strongly believe in including at least one free follow-up recheck appointment after each full treatment.

Equally as important as checking one’s own work, is to make sure that the client does not get reinfested.  Most people do not know the exact source of who they got lice from, or who they might have shared it with while they had it.  And most of us have to re-enter into the same environment where we contracted lice in the first place.  Chances of reinfestation are very real.  Whatever your choice for treatment, demand a recheck!

 

Lice Spies are professionally trained and certified through the Shepherd Institute.   We provide safe, non-toxic, natural head lice checks, treatment services, DIY & preventive products at our Edmonds’ clinic. Located on the corner of Edmonds Way/SR 104 and 236th St SW in Edmonds, WA, appointments can be booked online, anytime of day or night at www.licespies.com.  Follow us on Facebook.

 

Sources:

[1] Expansion of the Knockdown Resistance Frequency Map for Human Head Lice (Phthiraptera: Pediculidae) in the United States Using Quantitative Sequencing, by Kyle J. Gellatly, Sarah Krim, Daniel J. Palenchar, Katie Shepherd, Kyong Sup Yoon, Christopher J. Rhodes, Si Hyeock Lee, and J. Marshall Clark; Journal of Medical Entomology, 53(3), 2016, 653–659

[2] https://www.cdc.gov/parasites/lice/head/gen_info/faqs_malathion.html

[3] http://www.panna.org/press-release/global-chemical-treaty-adds-lindane-ban-list

[4] https://www.forbes.com/sites/melaniehaiken/2012/11/28/finally-a-new-head-lice-treatment-that-really-works/#5bf579e511c0

[5] https://www.researchgate.net/publication/267911183_The_Clinical_Trials_Supporting_a_Novel_Non-Toxic_Lotion_Benzyl_Alcohol_5_for_the_Treatment_of_Head_Lice

[6] https://bioone.org/journals/journal-of-medical-entomology/volume-48/issue-1/ME10122/Efficacy-of-the-LouseBuster-a-New-Medical-Device-for-Treating/10.1603/ME10122.short

[7] http://www.shepherdinstitute.com/

Lice Spies: spring clean because you want to, not because of lice

 

Your family had lice.  You all got treated – professionally, hopefully!  So what about your house – how do you clean after having lice?  Do you bomb the house?  Spray it down with the strongest pesticides there are?  Bag every last stuffed animal and pillow, and put them in the garage for a month or two?  How about washing everything in sight, steam cleaning carpets & upholstery, and dry cleaning your whole closet full of clothes?

The quick answer is, no!  Luckily we know a lot more about head lice than we did when we were growing up.  With some good lice facts, you will understand why cleaning your home, classroom, etc., does not have to be overwhelming.

Lice Facts

  • Lice are not like bed bugs: they do not burrow (like in mattresses, pillows, etc.) or live long off the head.
  • Most lice die after about 24 hours off a human head. They feed on our blood.  After about 12-15 hours off our head, lice dehydrate to the point where they cannot secrete saliva in order to feed.  If a louse was able to get back onto a head after the 12-15 hour mark, then that louse can no longer do any harm, like lay eggs.
  • Lice have claws at the ends of the 6 legs. They cannot jump or fly, they crawl.  So over 98% of the time, people get head lice from head to head contact.  This means that less than 2% of head lice transmissions come from the environment like: hats, coats, carpets, couches, theatre seats, airplane seats, helmets, stuffed animals, dress-up clothes, etc.
  • It is a fatal error for a louse to leave our head, unless it is going to another head that it senses is a better food source. We are their food and their heat source.  They really don’t want to leave our heads.

Cleaning Your Environment

Here are ONLY 5 things that you need to do to ensure your environment is not part of the less than 2%.

  1. Sleep in clean pajamas and on clean sheets (including pillow cases). Note: you do not need to clean pillows, mattress covers or mattresses.  Remember, they do not burrow like bed bugs.  There are options to sleep in clean sheets:
    • Sleep in another room that you haven’t slept in for 24 hours prior. Grab a sleeping bag and your pillow with a clean pillow case, and have a sleepover with popcorn and a movie in the family room for a night.  Or, pitch a tent in the backyard and have a camp out for a night.  Make lemonade out of lemons, and enjoy a fun, family bonding time; or
    • If you have a spare set of clean sheets for your bed, change out the sheets and put the old sheets in the laundry pile. Do laundry on laundry day as anything that would have been alive, will be dead by laundry day; or
    • Wash and dry existing sheets on high heat settings.
  2. Remove comforters or bedspreads for 24 hours, or put them in the dryer on high heat for 30-45 minutes.
  3. Lightly vacuum or lint roller couches, carpets and car seats, or throw a clean blanket or sheet over them for 24 hours.
  4. Usher all the stuffed animals into the coolest parties of all parties, to be held in the nearest closet for 24 hours. No humans allowed as the stuffies need their private stuffie party time.  If there are one or two favorite stuffie friends that absolutely need to sleep with your kiddo for the night, throw them in the party dryer on high heat for 30 minutes.
  5. Clean hair from combs, brushes and hair ties and:
    • Set aside for 24 hours; or
    • Put in a bag, in the freezer for 2 hours; or
    • Place in boiling water for 10-15 minutes (be careful of melting plastic though); or
    • Wash on high heat in the dishwasher.

Bug Bombs, Foggers & Sprays

Whatever you do, please do NOT bomb, fog or spray anything with pesticides or other chemicals in your environment for the purpose of head lice.  They are absolutely not needed and the risk of use is not worth the harmful exposure.

Lice have become almost 100% resistant to certain pesticides that just 20 years ago, were effective.  Read our blog article, “6 Month Head Lice Battle With OTC & Prescription Pesticides” for more information about why these chemicals no longer work in treatments – the same applies for when you release these toxins into the environment.

More importantly, these substances are very toxic.  Research has shown links to early puberty in boys, abnormal neurobehavioural development in children, certain cancers, etc.  Check out some articles posted on our “News” section of our website for further details.

Next Steps

Follow our 5 steps for cleaning your environment above.  It’s that simple!

Lice Spies are professionally trained and certified through the Shepherd Institute.   We provide safe, non-toxic, natural head lice checks, treatment services, DIY & preventive products at our Edmonds’ clinic. Located on the corner of Edmonds Way/SR 104 and 236th St SW in Edmonds, WA, appointments can be booked online, anytime of day or night at www.licespies.com.  Follow us on Facebook.

 

Mayo, Vaseline, Cetaphil, olive oil - do these work as home lice treatments? 

Head lice and home remedies… advice abounds from old wives’ tales passed down from generation to generation, to all those “expert opinions” that plague the Internet.  Smothering techniques are some of the most widely recommended methods of trying to tackle a case of head lice at home.  Does dousing your head in mayonnaise, olive oil, Cetaphil or Vaseline really work?

Let’s first look at the anatomy of a louse.  Lice have ventricles on the sides of their bodies, which when open, allow the bugs to breathe.  Lice can shut down these ventricles for up to two full hours, even when fully submersed in liquids that are meant to kill them.  If a louse can open these ventricles and grab a breath, they are good to go for another two hours.  Unless you are willing to dunk your head in a vat of these products for longer than two hours, the chances of still having live bugs in your hair is very possible.

What about the eggs or nits?  Surely, greasing up your hair will provide too slippery a surface for the louse to attach her eggs?  In addition, putting all that goop in your hair will suffocate any eggs that are already in your hair, right?  Unfortunately, no.  Leading lice PhD experts wrote an article in the Journal of Pediatric Nursing stating that none of these treatments stopped lice from laying their eggs [1].  It appears that of the oily products in question, petroleum jelly has the highest rate of killing some nits as the researchers observed only 6% of eggs hatched.

Do we recommend using petroleum jelly?  Absolutely not.  It is a nightmare to get it all out of your hair, and it is not 100% effective.  While a 94% success rate might be a very good passing grade in school, it is not a good enough result when treating a head lice infestation.  Leaving 6% behind in your hair can cause the whole hatching cycle to continue and voila, 2 weeks later your head is crawling with critters once again.

As for mayonnaise, we haven’t met one person yet who eats mayonnaise after suffering through a dreaded mayo lice treatment, even if it’s been years since the treatment!  All joking aside, please do not use mayonnaise.  Lice feed on our blood and can often create open bite wounds on the head.  Leaving a product that spoils very quickly on our heads for hours at a time can run the risk of salmonella poisoning.

The recommendation when using these oily products often requires you to place some sort of plastic over your head when sleeping.  In 2015, a precious 18 month old lost her life by suffocation while sleeping with her hair doused in mayonnaise covered by a plastic bag [2].  The risk is just not worth it.

Bottom line, there is no one product, tool or device that is 100% effective at killing lice and nits.  There just is not.  If olive oil really worked, the ancient Egyptians would have nipped head lice in the bud centuries ago!

The last two nits in the hair have to be removed to break the continuous loop of the hatching cycle to stop a lice infestation.  There are safe, effective tools and products that can help treat head lice faster and more efficiently, and they do not require multiple washings to get the products out of your hair.

Our recommendation is to seek professional help, preferably professionals that have been trained and certified through the Shepherd Institute [3].  These professionals can provide you with safe, effective, non-toxic DIY products and guidance for successful home treatments that are very reasonable.  They can also provide in-clinic or in-house treatment services.

Lice Spies are professionally trained and certified through the Shepherd Institute [3].   We provide safe, non-toxic, natural head lice checks, treatment services, DIY & preventive products at our Edmonds clinic. Located on the corner of Edmonds Way and 236th Street Southwest in Edmonds, WA, appointments can be booked online, anytime of day or night at www.licespies.com.

Sources:

  1. Home Remedies to Control Head Lice, Assessment of Home Remedies to Control the Human Head Louse, Pediculus humanus capitis (Anoplura: Pediculidae): Miwa Takano-Lee, PhD, John D. Edman, PhD, John D. Edman, PhD, Bradley A. Mullens, PhD, John M. Clark, PhD; Journal of Pediatric Nursing, December 2004 Volume 19, Issue 6, Pages 393–398.  http://www.pediatricnursing.org/article/S0882-5963(04)00139-3/abstract
  2. Massachusetts toddler dies during head lice treatment: CBS/AP February 5, 2015, 1:35 PM. https://www.cbsnews.com/news/massachusetts-toddler-dies-during-head-lice-treatment/
  3. http://www.shepherdinstitute.com/

head lice tea tree oilProbably one of the most recommended home treatment and preventive products for head lice is tea tree oil.  How effective is it, and are there potential side effects?

Tea tree oil, also known as Melaleuca oil, was originally derived (and still is today) from the leaves of the Australian tea tree shrub (Melaleuca alternifolia).  Since the 1980s, production has expanded to other regions of the world and is now from different species, all known as “tea tree oil”.  For example, Melaleuca armillaris and Melaleuca styphelioides hail from Tunisia and Egypt, while Melaleuca quinquenervia comes from the United States. [1]

Australian Aborigines have used the healing properties of the Melaleuca alternifolia plant for years.  In the 1920s, an Australian chemist by the name of Arthur Penfold, first published reports of tea tree oil’s antimicrobial activity.  Today, although scientific data is insufficient, anecdotal evidence suggests that tea tree oil’s benefits include antibacterial, antifungal, antiviral, and antiprotozoal properties (protozoa are one-celled organisms which can multiply in humans and create serious infections). [2]

But what about head lice?  Does tea tree oil work in killing adult lice, nymphs (babies, toddlers & teenage lice) and nits (eggs)?  Bottom line, there is no product, device or tool on the market today that kills lice and nits 100%.  Period.

OK, if no product, device or tool kills lice or nits 100%, then is tea tree oil safe and the best product to get rid of a head lice infestation or ward one off?  After all, Australian Aborigines have used the plant for ages.  And it’s an oil derived from a natural plant.  It has to be better than using OTC chemicals that are toxic and no longer work, right?

As for the Aborigines, they used the whole plant, not the processed oil.  OTC pesticide products are indeed ineffective nowadays, due to the increased resistance of lice in the last 20 years [3].  And yes, tea tree oil is a natural derivative of the plant.  However, most people don’t realize that there are potential side effects that you might want to consider before using.

There is evidence that tea tree and lavender oils, when used repeatedly on pre-pubescent boys, can cause enlarged breast growth.  Research is once again limited, but one study concluded that tea tree and lavender oils may have properties that disrupt hormones in young boys [4] [5] [6].  No known studies have been performed on young girls at this time.

Tea tree oil can also irritate your skin, so when used in strong dosages or in repeated low dose formulae, the result can be an annoying itchy head which can leave you wondering, do I have lice again?!  PTSD from a head lice infestation is very real.  Tea tree oil is quite toxic when swallowed so please be very careful when using around children.

If this information is enough to deter you from wanting to use these oils, then what is a better option for treating and preventing head lice?  We recommend mint.  Mint is a strong scent that the bugs just don’t like.  Mint-based sprays, shampoos and conditioners are great repellents.  Naturally occurring enzyme-based mint treatment products are also very effective at-home treatment options.  Again, no product is 100%, so you can still get lice using these preventives.  You can still have lice using the treatment products if you don’t get every last 2 nits out of your hair.  But using these products in conjunction with a great lice comb is the most effective means of dealing with lice.  For more information, check out our products listed on our website.

Lice Spies are professionally trained and certified through the Shepherd Institute.   We provide safe, non-toxic, natural head lice checks, treatment services, DIY & preventive products. Located on the corner of Edmonds Way and 236th Street Southwest in Edmonds, WA, appointments can be booked online, anytime of day or night at www.licespies.com.

Sources:

  1. Wikipedia: Tea tree oil. https://en.wikipedia.org/wiki/Tea_tree_oil
  2. Melaleuca alternifolia (Tea Tree) Oil: a Review of Antimicrobial and Other Medicinal Properties by F. Carson, K. A. Hammer, and T. V. Riley.  Clinical Microbiol Reviews, v.19(1); 2006 JanPMC1360273. 
  3. Lice Spies: https://licespies.com/6-month-head-lice-battle-otc-prescription-pesticides/
  4. Prepubertal Gynecomastia Linked to Lavender and Tea Tree Oils by Derek V. Henley, Ph.D., Natasha Lipson, M.D., Kenneth S. Korach, Ph.D., and Clifford A. Bloch, M.D.; The New England Journal of Medicine: February 1, 2007.
  5. The Mayo Clinic: Safety and side effects of tea tree oil. https://www.mayoclinic.org/drugs-supplements-tea-tree-oil/art-20364246?pg=2
  6. WebMD.com: Tea tree oil side effects and safety.  https://www.webmd.com/vitamins-supplements/ingredientmono-113-TEA+TREE+OIL.aspx