If anybody needs help with a difficult head lice infestation…
I recently eradicated a head lice infestation which was not stopped despite a regular regime of wet nitti-gritti type combing. My daughter has a lot of long hair and it seemed like we might never get it out of the family. After research and experimentation I came up with the following definitely works method.
It is a bit involved, but it works and involves a level of monitoring of the progression of the case which some people might appreciate. It takes ten minutes (less with short hair).
You will need some equipment, none of which is particularly expensive.
1) An electronic louse killing comb;
2)A double row head lice comb, Nitcomb M2
3) A powerful magnifying glass (this is just an example, any strong glass will do. You do need good light, the things can be very small and hard to see.
4) An old, white, plain weave, clean pillowcase.
5) A light to shine on head, portable lamp of some sort. (Optional, helps to see what you are doing)
6) Nitty gritty comb
7) hair conditioner
8) White clean china cup
- Read the instructions for the electronic comb and the M2 comb.
- Optionally, wash and conditioner / nitti-gritti comb hair. Hair must be completely dry and well brushed after, no tangles or knots. Get ends trimmed if they are a problem. The washing part is optional, the being dry and well brushed is not.
- Get all your gear laid out as you sit on a sofa or low-ish chair. The pillowcase goes on your lap, acrossways, to catch dead lice. The idea is that as you comb the hair any lice will be caught on the pillowcase, so experiment till you are happy with the arrangement. I used a small child chair with a back so her hair is 4-6” or so above the pillowcase on my lap. Be creative with the arrangement so it works easily for you.
- Sit the child in front of you on a low child chair, back towards you. They need to be seated well back towards you so their hair is hanging over the front edge of the pillowcase, above your lap but not touching it, or the lice will climb back on.
- Ask the child to relax back against the chair back. Tuck the pillowcase between the chair and their back, up behind their hair, to catch anything combed out of the hair. You don’t want combed out lice crawling around.
- Take electronic comb. Switch on. Makes high pitched buzz. Start at back. Keep comb as far as possible at 90 deg. to the skin. Avoid the ears, because comb can give an annoying but not dangerous buzzing sensation.
- Start at crown of child’s head and brush steadily down towards your lap. Don’t force through knots. Brush hair with brush or regular comb, don’t use nit comb to comb out knots. Keep comb ends against the scalp as best you can and follow profile of head at 90 deg., down all the way to nape of neck. Comb hair out all the way to the end, keeping comb at such an angle that any lice are held against comb and do not slip out the bottom. Draw the comb towards you such that as it pulls out of the hair, it is above the pillowcase on your lap, which should form a gentle depression, not stretched tight.
- Any suspicious objects that fall out examine with the magnifying glass.
- If comb stops buzzing it has or is electrocuting a louse. At this point keep combing down head, out towards you, as usual. Once comb is out of hair, turn it off. Keep hair and comb above pillowcase at all times. Using the magnifying glass, examine the comb and you will usually see something between the tines of the comb, if it hasn’t already fallen out. If it falls out the buzzing starts again. If the buzzing stops, and the hair is clean and (must be completely) dry, always assume it is a louse and not some random stop. You can tell this because later in the process when there are no more lice, the buzzer never stops. The juvenile lice are very small. If in doubt it is a louse.
- Use the little stiff bristled brush, that comes with the comb. Comb the metal comb tines, being sure to be above the pillowcase, onto the centre of the pillowcase.
- Any lice, alive, dead or not sure, tap gently from pillowcase into the smooth china cup. This can be tricky but you soon get the hang of it. I tapped it from below so the louse is dislodged from the pillowcase and flies/falls into cup, held just next to it with rim touching the pillowcase surface.
- Go back to step 6. Be very patient and systematic. Comb every last strand of hair. If in doubt do again and again. If you get a buzzing-stop but which starts again keep going at that bit, working the louse out and down. Work round head, being careful of ears. Do front with child facing towards you. Each time the comb buzzer stops, clear out comb.
- When whole head has been combed, some lice remain in hair, stunned, alive and untouched, or dead. Go through the hair with the M2 brush, but not as their instructions say. They say brush with the coarse gaps first then the fine, to trap the lice. You want to comb the lice onto the pillowcase so you can see them. This is the only way to know whether what you are doing is working. Comb so that the finest teeth go through the hair first. Comb in the direction such that anything caught in the teeth of the comb falls onto pillowcase. This gets quite easy with practice, and hair ends up super-combed as a bonus. Check all the time for suspicious objects on pillowcase. Check each one as it comes out so you begin to notice where they come from and what they are.
To start with if there is an active infection there will be a quite a few adult and immature lice. They live near the scalp so always make sure the comb is (gently!) drawn down against the scalp.
Even though one is thorough, it is amazing how some survive. Do this process daily, till the buzzer is not stopping at all and you are not getting anything onto the pillowcase.
Count the ones that end up in the cup. Keep track on a chart. Only adults lay eggs, so you need to keep going for two weeks after the last adult is killed. I got about 25 out in total, and that’s after weeks of nitti-gritti conditioner combing.
Getting to this point (no more lice, no buzzing stops) took two weeks for me.
At this point back off to every 2-3 days, for another two weeks. This is to catch any lice hatching out of eggs, which start very small. As they grow you stand more chance of catching them. Don’t be surprised if you catch one even after a period of being free. Keep on every 2-3 days until nothing has come out of hair for two weeks. At this point the head is free of lice and live eggs.
Repeat the process weekly for a couple of months to be sure, or just to deal with any reacquired from school. When you do it you will see how the lice events tail off till none are left. This is very satisfying.