Here is a link to a great information source. It is a health bulletin on head lice from the Cardiff and Vale University Health Board in Wales. It gives links to great research and what I love about it is that it includes wet combing as a main treatment in the fight against head lice: http://www.wmic.wales.nhs.uk/pdfs/bulletins/Head%20Lice%20Bulletin%20Jan%202014.pdf
While this publication also gives lots of information about chemical lice "treatments" (and you know I don't recommend them), it at least does not recommend products with permithrin (in Canada, this would be Nix which in my experience is the most prescribed lice treatment by health professionals). I like that this article says that you don't have head lice if you don't find a live louse on the head. (Old nits can stick around for a long time and do not indicate an active case of head lice.) Around wet combing, I have some different opinions than what is presented in this document - for instance, I have personally found metal combs to be more effective and I see no need to shampoo before a wet combing unless you want to. I also much prefer the use of conditioner over vegetable oils - conditioner is much less messy, smells so much better, and rinces from the hair easily, whereas vegetable oils often don't come out without a stronger detergent such as dish soap.
This publication mentions chemical treatments that are mechanical. What this means is that they don't kill the lice and eggs by poisoning them. (Nix and other permethrin based products do this - they are neurotoxins and the lice can adapt to these poisons over time.) Mechanical treatments coat the lice and eggs and kill by either drying out the shell of the bug or egg or by plugging up the openings (mouth and anus) of the bug. The idea is that because the animal is not affected by ingesting the product, they won't build a resistance to it. This may be a selling feature but I have been to many homes where all treatments we have available in Canada, including mechanical chemical treatments, have been tried according to the product directions and living lice were still found. Because the chemicals are not 100% effective, because they are costly, and because they all recommend manual lice removal to occur along with the treatment, I just think we should skip the unnecessary step and focus on the treatment that is readily available, cheap, and effective: Multiple wet combings over time until there are no new sightings of lice or their eggs. This document says that you can stop combing when you have had 3 thorough combings where no lice or eggs were found. On this blog, I say that you should have 2 weeks of combings with no sightings of lice or their eggs before you can say you are lice free. If the 3 combings listed in this document are 4 days apart from each other as recommended, it means you have to comb and find nothing for 12 days. 12 days. Two weeks. Almost the same deal.
Anyway, this bulletin is a nice, research based overview that for once does not say that lice are spread in hats and bedding. Check it out.
Here's a blurry picture of my cheap but good purple lice comb that I bought at Wal-Mart for under $10. I got to use it this evening. Tonight my daughter had a wonderful friend over. The friend was scratching her head at supper time so I asked about her head lice - my daughter told me she had been dealing with it. This girl said that her parent said her hair would be cut right off if they didn't get a handle on the lice soon. I offered to do a combing. After supper, we put on a movie (Puss In Boots) and got to work. She sat on a stool I sat on the couch behind her. I sprayed her hair with water, conditioned it, detangled it with a brush, and then started combing with the lice comb. Hundreds of eggs. Dozens and dozens of bugs. As I was combing, I told this friend that I would be sending the lice comb home with her so she could continue combing every couple of days. I was surprised at her response.
"Oh, we have that comb."
Upon talking to the parent later, I found out that comb had been used a couple of times but was then set aside because they didn't feel it was doing the job. Now, this girl had quite a lot of lice, so I do not know how the comb was being used or if it had really been used at all. I must mention that this parent is not neglectful. Time, energy, and money had been put into this problem; the parent tried to deal with the child's head lice by giving the child a lice "treatment', doing extra laundry, and spraying the furniture with some supposed lice-killing chemical. Attention was given to the problem. However, the problem didn't go away and for some reason, the lice comb was not really given a chance.
But it's the lice comb that works. So-called "treatments" and "shampoos" will not solve the problem. Spraying furniture does nothing. The key to beating head lice is combing over time. I told this parent to bring out the comb again and to comb every couple of days for a couple of weeks. The combing sessions don't have to be marathons - even just combing for a 1/2 hour every couple of days will lead to success.
If you are dealing with head lice, stop looking for the quick fix. Get combing and keep on combing until the lice and nits are gone. If the chemical treatments worked, I would recommend them, but they don't. A lice comb may not seem like a very snazzy solution and may not make the promises of a lice "shampoo", but it is simply your best tool in the fight against head lice.