Lice Treatment Warnings

Before using any product or treatment, you need to determine whether it’s appropriate in your specific situation. A head lice treatment may be appropriate and safe for one person, but carry unacceptable risks for another person of a different age or health status.That’s why it’s so important to consult your own doctor, before beginning any treatment. While I was researching head lice treatments, I found information that surprised me about possible health risks associated with ingredients in certain head lice products and home remedies.
I include a few examples on this page to demonstrate why it’s important to do thorough research.
The following examples are NOT comprehensive or complete. Always consult your doctor before starting any treatment.

Allergies

People can become allergic to any ingredient in any product. If someone in your family has allergies, then you probably already know how important it is to read ingredient lists carefully for known allergens. Even if there are no known allergies, products containing common allergens should often be tested by limiting exposure to only a very small amount at first, in a limited area, to see if a reaction occurs. Your doctor can advise you on this.

Plastic

NEVER use plastic wrap to cover kids’ hair. Use a shower cap or towel. Plastic wrap and plastic bags pose a suffocation risk.

Pesticides

Pesticides are not necessary to deal with head lice, and they should not be used on children. (You can get rid of lice and nits by combing alone. The only reason to use pesticides or any other product other than a good nit comb is to make the process easier and/or quicker … a potential benefit that does not justify the risk of putting pesticides on a child’s head.)

Lindane

According to an FDA Public Health Advisory, Lindane puts patients “at risk for serious neurologic adverse events, and even death, particularly with early retreatment”.

Permethrin

According to the Journal of Pesticide Reform, permethrin “is a neurotoxin. Symptoms include tremors, incoordination, elevated body temperature, increased aggressive behavior, and disruption of learning. Laboratory tests suggest that permethrin is more acutely toxic to children than to adults.”

Pyrethrins and pyrethroids

According to articles published at the National Institutes of Health, pyrethrins and pyrethroids “can induce adverse health effects, more often in acute poisoning, but also due to chronic exposure.”

Malathion

According to an article posted by the National Pediculosis Association, malathion is “chemically related to nerve gases developed during World War II. For decades, scientists have been debating whether such pesticides cause birth defects, cancers, and other health problems. Studies have shown links between regular exposure to malathion and various human maladies, including non-Hodgkins lymphoma, childhood leukemia, anemia, chromosome damage, and weakened immune systems ... Malathion and other pesticides are especially dangerous to children, who are more vulnerable to neurotoxins than adults.”

Alcohol

It’s probably never appropriate to apply an alcohol-based product to a child’s scalp and let it sit for any length of time. I would certainly never do this without asking my doctor first. For instance, trying the Listerine home remedy would likely not be safe for kids.

Coal Tar

I’ve seen Denorex and other coal-tar shampoos recommended as effective for treating and preventing head lice infestations. However, coal tar in high concentrations is classified by the World Health Organization as a cancer-causing agent. So, while I might consider using a coal tar shampoo once to fight a lice infestation, I would not use it regularly for anyone in my family.

Essential Oils

Lots of lice products contain essential oils. These are intended either to smother/kill lice, or simply to repel them. Often the marketers of these products promote them as totally safe to use, even on babies and young children.

However, many essential oils are not well studied. Some of them may well be safe to use frequently … but because they haven’t undergone rigorous controlled testing, it could be there are subtle harmful effects that haven’t been discovered yet.

Tea Tree Oil & Lavender Oil

For example, during my research into lice products I discovered that according to the National Institutes of Health, tea tree oil and lavender oil may have subtle hormonal effects when used long-term.

So, while I might consider using a product containing tea tree oil as a one-time event to treat head lice on my son, I would definitely not have him use a tea tree oil shampoo regularly in order to prevent head lice.

Eucalyptus Oil

According to the University of Maryland Medical Center, “Eucalyptus oil should not be applied to the face or nose of children under age 2. People with asthma should use eucalyptus oil with caution due to the herbs' potential to trigger an asthma attack. Pregnant and breastfeeding women should not use eucalyptus.”

Peppermint Oil

According to the American Academy of Family Physicians, “Peppermint oil should not be used internally, or on or near the face, in infants and young children because of its potential to cause bronchospasm, tongue spasms, and, possibly, respiratory arrest.”

Rosemary Oil

According to Baby Centre, pregnant women should not use rosemary oil at all as it may be harmful.

Mineral Oil

According to The American Head Lice Information Center, “mineral oil (including baby oil) is not recommended because it can be harmful to mucous membranes”.

Mayonnaise

Do not leave mayonnaise on a child's head overnight; it will turn rancid and the child could accidentally consume some of it.

Pregnancy

Pregnant women should check with their doctors before applying any treatment for head lice (either to themselves or to kids).

Oil and Petroleum

If you use a remedy with oil or petroleum products in it, you may need to shampoo the hair several times with clarifying shampoo or dishwashing liquid to wash all the oil out.

What do they look like?

• Tiny, wingless insects that move quickly and are difficult to see
• 1-2 mm long and greyish brown in color
• Nits (eggs) can sometimes be mistaken for dandruff

Common sites where head lice are found

Important things to remember

• Lack of cleanliness does not cause head lice
• Both children and adults can get it
• Short hair does not prevent the spread
• Lice do not live on cats, dogs or other animals
• You cannot prevent head lice by using head lice shampoos or products - use only if lice are present and as directed
• Be sensitive to your child’s feelings!

Head lice treatments

Talk to your doctor:

• if you are pregnant or breastfeeding
• before treating children under the age of two
• if a person has a seizure disorder
• if the skin of the scalp has an infection

• There are many products available at your pharmacy (talk to your pharmacist)
  • Buy a head lice shampoo or cream rinse from your drug store
  • Apply as instructed. Misuse and overuse could be hazardous
  • The products kill the head lice and many eggs, but a second treatment is needed 7 to 10 days after the first treatment to kill any newly hatched lice before they mature
• Remove all nits by using fingernails or a nit comb
• It is suggested that you limit shampoo use between the two treatments and in the week following the second treatment. This may allow the head lice product to work more effectively.
• Check head for live lice daily between treatments and remove any nits that are still present (do this in bright light)
  • head lice and nits are commonly found around ears, forehead and nape of neck - check these areas carefully
  • If live lice are found in the days following the first treatment, consult your pharmacist or call 416-338-7600
• Check all close contacts (i.e. family and friends)
• There is conflicting information concerning whether or not all nits should be removed after the application of head lice products
• Toronto Public Health recommends the removal of all nits as:
  • head lice products are not 100% effective
  • removal of nits may minimize the hatching of eggs that were not killed and the spread of young hatched lice to other heads
  • it is easier to notice a new infestation if all nits are removed
• If a baby or a woman who is pregnant or breastfeeding has head lice:
  • Call your family doctor or Motherisk Program of the Hospital for Sick Children at 416-813-6780 for advice before choosing a head lice treatment product
  • If pregnant and treating others, wear plastic or rubber gloves

Life cycle of head lice

Life Cycle consists of three stages:

• Nits (eggs)
  • oval, usually white in color, may be mistaken for dandruff, are firmly attached to a hair shaft, close to the scalp
  • take about 1 week to hatch into nymphs
• Nymph (baby louse)
  • lives on scalp and feeds off human blood
  • matures in 1 week into an adult louse
  • if a nymph falls off a person it usually survives only one day
• Adult Louse
  • size of a sesame seed, has 6 legs, and is tan to grayish-white
  • females lay nits - they are usually larger than males
  • can live up to 30 days on a person’s head
  • feeds on human blood
  • if a louse falls off a person, it may survive one to two days

Should the house be disinfected if someone has head lice?

Because head lice don’t live long off the scalp, there is no need for extra cleaning.
To get rid of lice or nits from items like hats or pillowcases:

• Wash the items in hot water and dry in a hot dryer for 15 min; or
• Store the items in an airtight plastic bag for 2 weeks.

What’s wrong with chemical based lice shampoos

The scalp is one of the most absorbent parts of the body. Products applied to the scalp go directly to the blood, without being filtered in any way. Pesticide based lice shampoos contain ingredients which are known or suspected to cause cancer, affect the nervous system, and have other harmful effects. They can trigger asthma or allergic responses. Children, especially children with asthma and allergies, are more vulnerable than adults to these chemicals.

The most common pesticides used in lice treatment in Nova Scotia are permethrin, pyrethrum, and piperyl butoxide. Lindane based shampoos are still approved for use in Canada, and in most provinces are available “behind the counter.” In the US, malathion based shampoos are still common.

Permethrin - A pyrethroid insecticide, permethrin is a synthetic version of an extract from the chrysanthemum. Exposure to pyrethroids has resulted in contact dermatitis and asthma-like reactions. Children with a history of allergies or asthma are particularly sensitive. Permethrin is a suspected human carcinogen and neurotoxin which has been reported to cause temporary nervous disorders in the face and hands. It is also a suspected reproductive toxicant and endocrine toxicant.

Pyrethrum - This is a natural insecticide made from chrysanthemums. Pyrethrum insecticide formulations often contain piperonyl butoxide, a synthetic chemical that increases the potency of pyrethrum. Pyrethrum can trigger allergic responses like skin rashes, hives and asthma. It is a suspected carcinogen, immunotoxicant and reproductive toxicant. Piperonyl butoxide is a suspected carcinogen, neurotoxicant and respiratory toxicant.

Lindane - Lindane was once the lice treatment of choice. It is now recognized as highly toxic, although lindane based lice control products are still approved for use in Canada. Lindane is an organochloride insecticide in the same chemical class as DDT. A nerve poison, lindane is readily absorbed through the skin and is classed as a known cancer-causing chemical in California where it is banned. Documented health effects of exposure to lindane include hormone disruption, dizziness, seizures, nervous system damage, immune system damage and birth defects. Lindane, also an agricultural pesticide, has been found in breast milk and blood samples throughout the world and is banned in at least 14 countries.

Seizures, behavioral changes, attention deficit disorders, brain injury, skin diseases, and even death have been reported to the United States-based National Pediculosis Association's registry by people who have used chemical treatments to get rid of head lice or scabies.

Lice Control DOs and DON’Ts

DON’T: Use pesticide based shampoos.

DO: Shampoo hair with normal shampoo. Use clips to divide wet hair into small sections, and work with one section at a time. Comb from the scalp, depositing lice and eggs in a bowl of soapy water. Some people report using conditioner and leaving it in the hair makes the process easier. Use a fine toothed, good quality metal comb.

DON’T: Use environmental sprays for lice - they are unnecessary and a serious health risk.

Lice infect people, not the home. They are human parasites. Lice cannot live without human blood for more than 24 hours. Nits will not live unless they get a meal of human blood immediately when they hatch.

DO: Vacuum carpets and padded furniture to remove any lice which crawl off the infested person, or hairs with attached nits is enough.

DO: Put bed linens, pillows, stuffed animals and similar items in a dryer for 30 minutes on high heat to kill both live lice and nits.

Lice do not jump or hop. They do crawl and cling. If a louse comes off the head and is left behind on a pillow, head rest, or hat, the louse may infect another person who places their head in that area. Vacuuming will catch these escapees. Experts used to suggest bagging items such as stuffed animals for several weeks to help control infestations, but this is now recognized as unnecessary.

DON’T: Treat family members who don’t have head lice. Treat for head lice ONLY when a person has them.

DO: Check everyone in the family using a good quality lice removal comb.

DON’T: Treat family pets for lice with insecticidal shampoo. Its pointless and potentially harmful (to humans and pets both). Lice cannot live on pets, so there is no reason to fear that lice may be hiding on your dog, cat or guinea pig.

DO: There really is no do for pets and lice. So give your pet an extra hug and be thankful. DO: Consider exploring safe options for flea control for your pets (see www.environmentalhealth.ca/summer01flea.html)

DON’T: Use head lice treatments as a preventative measure. Head lice can’t be safely or effectively prevented by shampooing with either chemical or alternative treatments.

DO: Practice early detection, by making weekly head checks with a good quality comb. Early detection and removing any live lice or nits can keep head lice problems to a minimum. “It only takes a few minutes,” says Bonnie Byers, parent of four. “I check around the ears, the back of the neck, around the bangs and where hair is parted. Lice seem to like these areas best.”

DO: Visit www.headlice.org for a wealth of information on non-toxic lice control, including a video on effective combing methods, and pictures of lice and nits.

The Key is in the COMB!

( Quote ) The Lice Problem - if you’re a parent you’ve probably had to deal with it at least once. And you dread having to do it again. Every school year, thousands children get head lice. More and more, parents are finding that chemical based lice shampoos just don’t work. Not knowing what else to do, many parents shampoo again with the same, or another, pesticide based lice shampoo, use pesticide based lice sprays on carpets or furniture, wash bedding and clothing over and over, in an attempt to solve the problem. The costs and frustrations mount - and so do the exposures to harmful chemicals. And often, the lice remain.

Head lice can be eliminated - and they can be eliminated without using toxic chemicals, and without spending lots of money. The key is in the comb. A recent study in the British Medical Journal found that finely combing wet hair with a comb specially designed for head lice was four times more effective in getting rid of head lice than malathion or permethrin based lice shampoos. The National Pediculosis (the scientific name for lice) Association agrees. This non-profit group has been working for years to help parents eliminate lice without exposing their children to harmful chemicals.

Their message is comb, comb, comb, but make sure you are using a comb that works. The right comb will be metal, have long teeth finely spaced, and the space between the handle and the teeth will be sealed, so that live lice can’t hide inside. Many combs sold with pesticide based shampoos are not fine enough or strong enough to be effective in removing all lice and nits, the lice eggs which attach to the hair shaft. This is one of the reasons that these products don’t work. Another reason is that many lice have become resistant to the most commonly used pesticides in lice shampoos. The NPA recommends combing hair wet and using the LiceMeister brand comb, which is the only comb which has met their standards for lice control.

Pesticide based lice shampoos are dangerous. They can have harmful immediate and long term effects ( see sidebar). The number of parents who choose not to use pesticide based shampoos is growing. These safety-conscious parents do not want to apply a pesticide to their child’s scalp, and have it absorbed into their blood and circulated throughout their bodies. Perhaps they also realize that lice appear to be developing resistance to the pesticides, just as many bacteria have developed resistance to the overused antibiotics. A side benefit is that these parents are also not sending these pesticides into our wastewater and thus eventually into our groundwater.

There are some non-pesticide based shampoos on the market including several using tea tree oil as the active ingredient. These ingredients are less hazardous than pesticide based shampoos, and lice have not developed resistance to them. However, tea tree oil products can create allergic sensitization, so should be used cautiously. Tea tree oil shampoos should be tested on a small area of skin to make sure the user isn’t allergic before applying to the scalp. Pure tea tree oil is a sensitizer and should not be used.

There are some home remedies which have had reported success, but haven’t been fully proven. These include covering the head with mayonnaise, olive oil or vaseline and leaving it on overnight. In all cases, effective combing needs to be done to remove nits. Some products advertise that they kill all lice and nits without combing, but there is no evidence so far that this is true.

The LiceMeister comb is not widely available in Atlantic Canada, but any pharmacy or individual can order the comb from CanCoast Holdings, 1-877-410-LICE. Stores which do stock the combs have usually brought them in when a relieved and satisfied parent who has used the product brings it to their attention. In southern Ontario, some schools have a comb loan program, where LiceMeister combs are lent to parents whose children have lice, and returned when the problem is solved.