Anecdotal reports of a global increase in head lice cases have prompted warnings from some experts about a popular and universal activity among children and teens: taking selfies.
Head lice, itchy parasites that live on the scalp, are generally transmitted by direct contact between heads, mainly between children. And getting close to take group selfies – which often means pressing two or more heads together to fit them into the frame of a cell phone – can give head lice the opportunity to crawl around. ‘head to head, because they cannot jump or fly.
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Selfies “constitute an important source of transmission,” Federico Galassi, a researcher at the Pest and Insecticide Research Center in Buenos Aires, said in an email.
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Are lice on the increase?
It is unclear whether head lice outbreaks are getting worse. So far, experts say, this has not 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 increase in demand for their services.
“We’ve seen growth across the country,” said Krista Lauer, national medical director for Lice Clinics of America, a national lice removal company, which saw an 18 percent increase in in-clinic treatments and a nearly 20 percent increase in sales of lice products over the 12 months 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 was particularly quiet, but business started to pick up late last summer and she’s seen “a significant increase.” And Lice Squad, which has clinics across Canada, has seen about a 50 per cent increase in requests for service over the past year, said Dawn Mucci, the company’s founder and CEO.
“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 failed 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.
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The return of lice
Some experts have said many countries may simply see a return to pre-pandemic lice levels. Lice outbreaks declined sharply early in the pandemic, when most children were not allowed to go to school or daycare or participate in after-school activities. Studies in the United Kingdom, Argentina, Poland and elsewhere have reported pandemic declines in lice infestations among schoolchildren.
“We know that children are back in class, playing together, playing sports and doing the activities they used to do,” Albert Yan, a pediatric dermatologist at the hospital for children of Philadelphia and one of the authors of the American Academy of Pediatrics clinical report on head lice. “It is not surprising that we are returning to what I suspect are more expected levels of head lice infestation. »
Ian Burgess, director of the Centre for Medical Entomology in Cambridge, said it could be interpreted as a surge, “but it’s a bit like waves in the water, just rippling up and down”.
At least one expert is skeptical, however, saying that because many reports of lice infestations come from commercial lice removal clinics, 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 presumed to have lice did not have them. Many had other types of bugs in their hair – aphids, ants, beetles – from outdoor play, or other culprits including dandruff, hairspray residue and even cookie crumbs, she said. -he declares.
Or, other experts say, it could be that clinic visits are increasing 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 been declining for several 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% from the prior year. Compared to the same period four years ago, unit sales were down 33%.
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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 head lice (vinegar, isopropyl alcohol, olive oil, mayonnaise, melted butter, and petroleum jelly) and found that the only product that caused significant mortality in the 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 against lice in South America, can work but their effectiveness varies. Research shows that eucalyptus, pennyroyal, marjoram, and rosemary may be helpful in treating head lice. And a study in Israel found that a lemongrass formulation 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 has said essential oils should not be used on babies, children or adolescents. .
“Parents should avoid topical remedies that have not been proven effective in patients with 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 prescription and over-the-counter lice products consist of a topical agent such as shampoo that aims to kill lice and their eggs, sometimes called nits.
A challenge with using over-the-counter topical medications at home is that many people don’t understand the life cycle of lice, said Sherry Torkos, a pharmacist in Ontario. Often, these chemicals must 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 perpetuates itself,” Torkos said.
Additionally, research shows that lice have developed resistance to many over-the-counter lice products that contain permethrin and pyrethrin, which are insecticides. A prescription pest 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 at Amherst.
There are also products containing dimethicone, an insecticide-free silicone polymer that suffocates lice, killing them at all life stages, experts said.
A Food and Drug Administration-approved medical device used at Lice Clinics of America uses heated 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, blasting hot air dehydrates and kills them, said Clark, whose lab helped test the product .
Experts have urged caregivers not to use hair dryers to achieve similar results, as it could burn the scalp or spread lice to other people.
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How to prevent head lice?
Lice are a common concern during childhood and are not related to personal hygiene. There is no surefire way to prevent them, but caregivers should check their children’s heads regularly for lice, especially when children 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 the practice.
Additionally, caregivers should encourage children to avoid direct contact, especially with anyone who may have lice.
Children with long hair can reduce their risk by tying their hair in a ponytail or bun during activities that require close contact with other children to try to prevent their hair from getting mixed up.
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