LICE - Eeek!

Let me start by saying I am not happy about being an expert on this subject. I would much rather have gained just about any other expertise as a result of fostering. But, since I had no choice in the matter, I guess I'll use my lice expert powers for good rather than evil.

Here are some of the many things I have learned about lice management, treatment and prevention. Just tuck them away (or bookmark this page) in the unfortunate case that you ever need them:

1. Lice are not easy to see and if you don't know what you are looking for, can be easily missed in a head check.

2. Contrary to popular belief, lice do not like dirty, greasy hair.

3. Lice shampoos do not work as directed on the packaging.

4. There are lots of other necessary steps in addition to treating with shampoo.

5. Combing out nits is not as easy as it sounds.

6. All nit combs are not created equal.

7. It takes longer than you think to completely get rid of lice.

8. If you know someone has it, it's actually easier to keep from spreading to other people in the house than you might think.

9. Coconut oil is my friend.

10. Freaking out, yelling at kids, threatening to shave people's heads really does not help the situation.


First, what are you looking for?

The first time we dealt with lice, our 5 yo foster daughter was scratching her head a lot. She even told me she had lice (apparently she had it before, so she knew what she was talking about - eventhough she called them "fleas"). Now, if you know little Jenny*, you know that she thinks she has every single ailment under the sun. So, I didn't believe her. But I didn't want to ignore it, so I looked in her hair.
Looked fine to me!
The reality is, I had no idea what I was even looking for. I guess I thought it would be really obvious as soon as I looked in her hair. Well, it's not.

Here is what the bugs look like:

This is a blown up picture, so they are much smaller than this. As you can see they look different depending on their maturity. It takes them about 10 days to get to mature adults that can lay eggs. When doing a head check on an itchy kid, don't expect to see these guys. They move very quickly and are very hard to spot. It's not until you have treated the hair, that they begin to slow and die and then are easier to see. Also, when combing out the hair, you will likely see some both dead and still moving slowly. But don't expect to check a kid's hair for lice and see bugs.

What you will see instead are the nits:

These are very tiny and also very hard to see, especially if you don't know what you are looking for. Is it dandruff, food, dirt, lint? It really is pretty hard to tell.

Here is what distinguishes nits from dandruff, food, dirt, lint:

* Nits are attached to the hair shaft with a strong "glue". If you see what looks like a nit, but it easily comes off the hair (from just movement), it's not a nit.

* Nits are tear drop shaped and almost translucent white, however, as the lice grows in the egg, it becomes more brown. So, don't expect to see a big white egg (that's what I was looking for).

If your child has lice:

There are some different options here. You can purchase lice shampoo and treat with that first. Then follow up with the coconut oil treatment I will explain here. Or you can skip the lice shampoo and go straight to coconut oil treatment.

How to decide?

It's totally up to you. We used lice shampoo the first time because we didn't know any other way. We also followed the directions on the shampoo packaging because we didn't know any better. The first time, we not only had 5 yo Jenny* with lice, but also 4 yo Molly* and 2 yo Shirley* who all shared a room. It had not spread to anyone else in the family (2 adults and 3 other kids) who did not share a room with Jenny. If you have a bit of an infestation like we did (she had an itchy head for a while and had spread it to 2 other kids before we identified it), you'll probably want to do the shampoo. In subsequent "outbreaks", we caught it early, contained it to only one child and opted to skip the shampoo method.

Part of why I do not use the lice shampoo, is because I have found that I don't need to use it, to get rid of the lice. I'd rather not put all of that pesticide on my kids heads if I don't have to. I'm not even a fan of using commercial shampoos because of the toxins I'm worried will absorb into the blood stream via the scalp. So, all of the heavy duty pesticide in those shampoos is not really something I want to use unless I have to.

I also do not find that it works better. So, it is not a matter of using a less effective alternative in order to avoid chemicals. It's just as effective of an alternative (in my opinion). Another reason, lice shampoos are expensive. My husband, however, has more peace of mind when we use the shampoo. So, if that is where you are at, I totally get it.

If you use the shampoo:

1. Keep it on the hair for an hour (or as close to an hour as you can get 45+ min.) - the packaging says 10min. That does not work. Per the nurse at our pediatrician's office, it is because the lice have become more resistant to the pesticides, so it takes much longer exposure to kill them.

2. Comb out the dead bugs - do not use the stupid plastic combs that come with the kit. They don't work. Instead buy the metal ones that look like this:

Don't bother with the gel that comes with the kit either. It gets so gooped up, you can't even tell what you are combing out or if you are even getting anything. Just comb through the wet hair after rinsing out the shampoo.

3. Wait the 2 days as stated on the package before going to the coconut oil treatment.

4. Wash all clothing, bedding, towels in hot water immediately after use. You will want to do this every day until you are sure the lice are gone. This can be one of the more frustrating parts of dealing with lice. We had 3 little girls who took naps every day, so I was washing bedding for 3 beds 2x per day.

After shampoo or instead of shampoo - coconut oil:

1. Buy yourself a jar of coconut oil:

When you have time, google all the great uses for coconut oil. You'll be wanting to keep a couple of jars on hand.

It will likely be solid when you buy it. It has a very low melting temp, so as soon as summer hits here in Phx, it stays in liquid form at room temperature.

2. Coat the hair with coconut oil. If it is solid, scoop some out, rub it in your hands (this will melt it quickly), then rub it all over the hair. Make sure to get a good coating all over the hair.

3. Comb out the hair (use the metal comb - see above). The coconut oil will not kill the bugs the way the shampoo will, but it will slow them considerably. The coconut oil makes the hair too slippery for the lice to cling to, so they are easier to comb out. If you have already used the shampoo method 2 days earlier, you may be combing out dead bugs that you missed the first day. Otherwise, expect live bugs. I keep a small bowl (actually an old sour cream container) with hot water and vinegar right next to me while I comb as well as paper towels. You will need to clean out the comb frequently (basically every pass through the hair). So, the bugs and nits go straight into the hot vinegar water as I comb them out. Lice cannot live in high heat, so the hot water should kill them, but I also use vinegar b/c, well, I use it on everything.

4. You can wrap the head in a shower cap if your child will keep that on. We tried saran wrap, then shower cap. It didn't really stay on and it isn't really necessary. Just leaving the coconut oil in the hair makes it hard for the bugs to move and makes it hard for the nits to glue to the hair shaft. If the hair is dripping with oil (it shouldn't be after combing it out), you can blot it with a paper towel. But, keep the oil in the hair for a couple of days (2-3), combing through each day. This will get oil on clothes and bedding. I have not had an issue with it washing out though.

5. Shampoo the hair with regular shampoo, then rinse with vinegar. Lice do not like vinegar and it also helps dissolve the "glue" that holds the nits to the hair. Also, apple cider vinegar is a natural hair conditioner. Rinse with vinegar, then rinse out the vinegar with water.

6. You can also blow dry the hair since the heat can kill the lice too.

7. Continue to comb out hair daily until you are no longer finding nits. Check the hair periodically even after you stop finding nits to make sure you didn't miss any. Nits will hatch after about 7-10 days then take another 10 days to mature to lay more eggs. So, if you miss any nits, you want to be sure you are regularly checking so that if they do hatch into bugs, you can get them out before they lay more eggs. I find combing them out with the oil in the hair to be much easier and more effective, but I do like to comb dry hair every once in a while, because they are easier to see in dry hair.


Home Care:

1. Make sure to wash all bedding, towels, clothing and anything else that is washable in hot water immediately after use.

2. Vaccum carpets, couches, car seats, mattresses and anything that cannot be washed. We also use lice spray (it smells like bug spray) on all of these surfaces before and/or after vaccumming at least once per day. Luckily, we have leather couches and leather interior in the car, so there was less to have to spray.

3. Pillows and stuffed animals and other items that cannot be washed can be put into black trash bags, tied up tight and left sealed for at least 10 days. Some things that I have read said to keep it tied up for 30 days. I really can't see why that is necessary since lice cannot live off the human body for more than 4 days or so (and that is in mild temps - shorter for hotter temps). Nits can live off the human body for up to 10 days, but will not hatch in high heat (or extreme cold). We left ours in the garage (and in Phx, that's HOT). You can also put those items in the dryer on high heat. Honestly, we threw a lot of these things away the first time. Partly due to paranoia and partly because we really had no idea how bad everything was since it took us so long to catch the lice in the first place. Since that first time, we have dealt with it several more times because one of our placements was having overnight visits with bio parents and came home with lice every time. So, once a week, we had to manage and treat lice. Fun, fun!

Prevention:

Once we had one of our kiddos coming back every week with lice, we had to be in prevention mode for the rest of the family. Obviously, no sharing brushes, hair products, towels, bedding etc. We kept everything cleaned as described above in Home Care.

Some other things to do:

1. Coconut shampoo - lice don't like coconut (I don't know why), so some people use coconut shampoo regularly (even the cheap Suave stuff).

2. Vinegar - do a vinegar rinse once a week. Again, this is a good natural conditioner. Also, lice do not like it.

3. Tea Tree Oil - lice do not like this either. You can put a few drops in your regular shampoo as a preventative. There is a lice shield spray on the market that has a tea tree oil type smell (it might be eucalyptus or something). Our school nurse recommended this spray. You could make your own with tea tree oil or add it to the shampoo for the same effect.

4. Coconut oil treatment - this can also be done weekly or a couple times a month. Lots of people like how soft their hair feels afterward.

5. Keep the infected child's hair greasy with coconut oil and pulled back as much as possible.

If you regularly check your kids hair for lice, you can make sure you catch it quickly which makes it much easier to get rid of. Once we knew our 2yo was coming home with it after every visit, we were able to keep it just to her and none of the other family members ever got it. That is with a 2yo running around and getting into things, playing with the other kids etc, not being careful not to spread it (you know, typical 2yo stuff) and we were still able to prevent everyone else from getting it.

If you stay calm and realize it is a process and not to panic, you'll be fine. You are not going to get it all out in one day. It takes a little while. You need to be ok with the fact that it will still be in their hair for a while before it is completely gone. Just use the preventative tips for yourself and others in the home and keep working on the infected child until it's completely gone.

It's also good to remember that lice spreads by the bugs. The bugs are killed by the shampoo or the oil treatment and after that you are working on getting nits out. Although the nits can get onto things, if you are washing well and not sharing items, it's not that easy to spread. If you are combing and checking regularly any newly hatched nits should be caught before they can spread and lay more eggs. When you remember that, it's easier to be calm knowing there is a kid with a head full of nits running around your house.

The first time we had it, I felt this urgency to get it all out right away. This was impossible which made me absolutely crazy. I spent 2 hours each morning and 2 hours each night combing out hair. This lasted for 2 weeks. The kids were basically "quarantined", not allowed to play like normal, sit on anything etc. because we were so panicked about spreading it. I felt like we would never get a handle on it. I almost killed everyone in the family with all of my stress over the situation.

Once I learned how to manage it, I'm much calmer about it. It's not that hard to manage if you know what you are doing and it will go away.

I hope this was helpful. My head feels itchy now!