Selfies “are an important source of transmission,” Federico Galassi, a researcher at the Center for Pest and Insecticide Research in Buenos Aires, said in an email.
It’s unclear whether lice outbreaks are getting worse. So far, experts say, that hasn’t been widely demonstrated in the scientific literature, although anecdotal reports suggest it may be true. Some head lice removal clinics in North America and parts of Europe are reporting an uptick in demand for their services.
“We’ve seen growth across the country,” said Krista Lauer, national medical director of Lice Clinics of America, a national lice removal company, which has seen an 18 percent increase in clinic treatments and a almost 20 percent increase in clinic treatments. sales of anti-lice products over a 12-month period ending in April.
Clinics outside the United States are reporting similar situations. Shawnda Walker, owner of Nitwits, a lice removal clinic in Toronto, said 2022 has been particularly quiet, but business began to pick up late last summer and she saw “a significant increase. And Lice Squad, which has clinics across Canada, has seen about a 50 per cent increase in service requests over the past year, said Dawn Mucci, the company’s founder and chief executive officer.
“We are seeing the same thing in the UK,” Dee Wright, owner of Hairforce, which has six clinics across the UK and is in the process of opening a seventh, said in an email about the increase in demand. “Our clientele shows war weariness.”
Clinic owners said many clients seek professional help after unsuccessful attempts at home treatment.
Jennifer Rosa, owner of two Lice Lifters clinics in Plymouth Meeting and Washington Crossing, Pa., said many caregivers who bring their children have already tried prescription treatments, over-the-counter products or home remedies.
“They’re not working, that’s why they’re turning to us for help,” she said.
Some experts have said many countries may simply see a return to pre-pandemic lice levels. fell sharply at the start of the pandemic, when most children were not allowed to attend school or daycare or participate in extracurricular activities. Studies in the United Kingdom, Argentina, Poland and elsewhere have reported pandemic declines in lice infestations among schoolchildren.
“We know that kids are back in class, playing together, playing sports, and doing the activities they used to do,” Albert Yan, a pediatric dermatologist at Children’s Hospital of Philadelphia and one of the authors of the American Academy of Pediatrics’ clinical report on head lice, said by email. “It’s not surprising that we’re returning to what I suspect are more expected levels of head lice infestation.”
Ian Burgess, director of the Cambridge Center for Medical Entomology, said it could be interpreted as a surge, “but it’s a bit like waves in water, just rippling up and down.”
At least one expert is skeptical, however, saying that since many reports of lice infestations come from commercial lice removal clinics, the anecdotal reports may reflect marketing efforts.
Richard Pollack, a public health entomologist at Harvard University who has studied the overdiagnosis of lice infestations, reported that in his research, the majority of children suspected of having lice did not actually have them. Many had other types of insects in their hair — aphids, ants, beetles — from outdoor play, or other culprits, including dandruff, hairspray residue and even cookie crumbs, he said.
Or, other experts say, it could be that clinic visits are on the rise because lice have developed resistance in some areas to the over-the-counter lice products people use at home.
In the United States, unit sales of lice treatments have declined in recent years in brick-and-mortar stores, according to data from research firm NIQ. During the 52-week period ending May 18, unit sales declined 1.5 percent from the prior year. Compared to the same period four years ago, unit sales were down 33 percent.
How to get rid of lice ?
Head lice, which are generally considered a mere nuisance, are treated with prescription or over-the-counter topical medications, home remedies or by repeatedly combing lice-infested hair, although experts say combing alone isn’t enough to eliminate lice. Some people use olive oil, mayonnaise or conditioner sprinkled with baking soda to smother or trap live crawling lice, then comb repeatedly with a fine-toothed comb to remove both live lice and unhatched eggs that have attached themselves to the hair, as well as empty eggshells. However, many home remedies are time-consuming, messy and don’t kill all lice and their eggs, some experts say.
In a 2004 study, researchers tested six home remedies for lice – vinegar, isopropyl alcohol, olive oil, mayonnaise, melted butter and petroleum jelly – and found that the only product that caused significant mortality in lice was Vaseline. This treatment was difficult to remove from the hair and none of the treatments stopped the lice from laying eggs.
Some essential oils, more commonly used for lice in South America, can be effective, but their effectiveness varies. Research shows that eucalyptus, pennyroyal, marjoram, and rosemary may be helpful in treating head lice. A study carried out in Israel also found that a lemongrass-based formula was effective as a repellent against them. But until more data is available on the safety of essential oils for treating head lice, the American Academy of Pediatrics says essential oils should not be used on babies, children or adolescents.
“Parents should avoid topical remedies that have no proven efficacy in patients with head lice,” Matthew Falagas, director of the First Department of Internal Medicine at Hygeia Hospital in Athens and assistant professor of medicine at Tufts University School of Medicine, said in an email.
Most lice control products, whether prescription or over-the-counter, contain a topical agent, such as shampoo, that is designed to kill lice and their eggs, sometimes called nits.
One challenge with using over-the-counter topical medications at home is that many people don’t understand the life cycle of lice, said Ontario pharmacist Sherry Torkos. Often, these chemicals need to be applied more than once, including a reapplication seven to nine days after the first treatment to kill any eggs that survived and subsequently hatched.
“If you don’t kill the lice and the eggs, the cycle continues,” Torkos said.
In addition, research has shown that lice have developed resistance to many over-the-counter lice products that contain permethrin and pyrethrin, two insecticides. A prescription lice control agent known as Natroba has replaced permethrin as the standard treatment in the United States, said John Clark, a pesticide toxicologist who studies lice at the University of Massachusetts Amherst.
There are also products containing dimethicone, an insecticide-free silicone polymer that suffocates lice, killing them at all stages of their life, experts said.
A Food and Drug Administration-approved medical device used in lice clinics across America uses hot air to eradicate lice and their eggs in a single treatment. Because lice don’t have a heavy exoskeleton and aren’t well protected against water loss, blowing hot air dehydrates and kills them, explained Clark, whose lab helped test the product.
Experts have urged carers not to use hairdryers to achieve similar results, as this could burn the scalp or spray lice onto others.
How to prevent head lice?
Lice are a common problem in children and are not related to personal hygiene. There is no surefire way to prevent them, but caregivers should regularly check their children’s heads for lice, especially when they scratch, said Kate King, president of the National Association of School Nurses.
Although sharing brushes, combs and clothing such as hats is not a common way to spread lice, King advised against it.
Additionally, caregivers should encourage children to avoid head-to-head contact, especially with anyone who may have lice.
Children with long hair can reduce their risk by pulling their hair into a ponytail or bun during activities that require close contact with other children to try to prevent their hair from getting tangled.