1. Don't Panic!
2. You don't need to run to the store and get a pesticide-based lice shampoo, or a lice spray for your house or school. There are alternatives that are more effective than pesticidal shampoos for eliminating lice. Also, spraying the physical environment will do absolutely nothing for the head lice problem - except potentially make the children (and adults) ill. The National Pediculosis Association and the well-known Bio-integral Resource Center (BIRC) recommend that you do not spray the physical environment as there is no evidence that pesticide treatment of the physical environment is effective in the treatment of head lice. ^1,2

The following are the best ways we personally found worked when we had to help an employee who was struggling to stop a lice infestation in her household. The recommendations are based on my research into this issue, and from talking to pharmacists and doctors that deal with chemically injured patients who can not use pesticides. Please keep in mind that this is not medical advice, nor is it intended to replace medical advice.

1. Educate yourself - you can learn everything you need to know in a half an hour to an hour. The best sources of information are from the National Pediculosis Association (in Newton, MA: 616-449-6487 and BIRC (in Berkeley, CA: 510-524-2567). The NPA has good basic information on lice, and BIRC has an outstanding written document (the Fall, 1998 "Commons Sense Pest Control Quarterly) full of excellent least toxic 'how tos' in terms of dealing with head lice. ^1,2,3
   br> The National Pediculosis Association (Pediculosis = head lice) also has a good web site, at http://www.headlice.org that will give you current information on what they have available, and on what to look for when dealing with lice.
2. Clean up the infected person or child. We were able to do it without pesticides following proven mechanical methods that help you comb the adult lice and nits out of the hair. These methods may suffocate some of adult lice and nits (eggs) on the person's head, but you must also comb with a lice comb .
   
   You can use vasoline (if the individual isn't chemically sensitive to it - it's hard to get back out of hair though!), coconut or olive oil (you can use any salad oil, but coconut or olive oil are the best) to make it easy to comb out the lice and eggs. Saturate the hair and scalp with the oil, leave it on for 20 to 30 minutes, and thoroughly comb the hair from the scalp outwards with a metal lice comb to remove dead adults and all lice eggs stuck on hair (see references at the end to order a metal lice comb if you can't find one locally). The oil prevents the hair from tangling and also makes it very easy to comb through the hair. If you have never done this, it is tedious - you need to do a small section of hair at at time. The 1998 BIRC article has excellent and detailed instructions on how to do this. ^1,2,3
   
   For our employee, we found this worked, while the pesticide laden products did not work. The head should be examined every day and combed with the metal lice comb to remove eggs ('nits') if any are found until two weeks after the last nit/adult is gone. In one case I know of personally, the individual used the pesticide shampoo unsuccessfully for six weeks (once a week), and was able to get rid of all the lice and nits by using the oil/vasoline method just once, followed by one week of diligent combing to remove nits with a metal lice comb.
   
   Special note: absolutely avoid the prescription shampoos, which contain the pesticide lindane. Lindane is a very toxic organochlorine pesticide. Organochlorine compounds which have chlorine atoms attached to one or more carbon rings are called organochlorines. Pesticides within this chemical group are usually highly toxic - examples include DDT. Non-pesticide organochlorine compounds include substances like dioxin and PCBs. Lindane is neurotoxic, causing grand mal seizures, and it is highly carcinogenic in laboratory tests. It also causes aplastic anemia, as well as other blood disorders. ^{6,7,8,9,10,11,12,13,14,15,16,17}. The NPA specifically recommends you never use these prescription shampoos ("Kwell" is the name of one of them) as lindane can "attack and permanently damage the central nervous system." ¹
3. Clean up the infested person's clothing and bedding.
   • This requires washing clothing and bedding in a washing machine at a water temperature of 120 to 130F, 20 minutes of actual agitation time. It needs that long a time of exposure to the hot water to kill adults and eggs.
   • The actual bedding (mattress and pillow etc.) should be vacuumed thoroughly daily, as should other areas the person frequents. Vacuuming is incredibly effective!
   • When cleaning up clothing, don't forget to clean brushes, combs, hats, hair clips and hair ties - minimum of 20 minutes in hot soapy water.
   • Use an oil based shampoo (such as one that contains coconut oil) for daily hair washing and for washing combs. Until the house and person are lice free, make sure dirty laundry is stored in sealed plastic bags (or washed as above immediately) until washed to prevent re-infestations. We used Dr. Bronner's unscented baby castille shampoo to wash combs etc., and for the laundry, since it contains coconut oil, johoba oil, and olive oil.
4. Items that the person is around which are fabric (like stuffed animals) which can't be washed should be sealed in plastic bags for a minimum of two weeks. Alternatively, they can be placed in sealed plastic bag and frozen for 48 hours.
5. Furniture, carpeting and floors should be thoroughly vacuumed daily. Vacuuming daily is highly recommended! Toss the bag after each vacuuming! Don't waste your time and energy shampooing your carpet or furniture - it isn't effective. Once again, pesticide spraying of these items is not recommended - it's toxic, and it simply isn't effective. ^1][2][3
6. In a school setting, every child should be examined in the morning before being allowed in the classroom by someone who is experienced in checking hair for lice and eggs. This checking should be done using lice sticks (basically, cheap wooden sticks you toss in a plastic bag that you seal shut and throw away) - a new pair of sticks for every child. Checking each child with your fingers is a grand way to pass along an adult louse from one child to the next. Children with lice should be sent home to be deloused. These sticks, btw, are usually called 'pedicul-sticks' and are available from the National Pediculosis Assn.
7. Children's clothing (hats, scarves, coats) should be separately bagged, not hung side-by-side, using plastic bags, until all children are clear for at least two weeks. Make sure things like 'dress-up' clothing is not shared, and make sure things like hats, combs, brushes and sports equipment lilke batting helmets, or electronic gear like headphones are never shared either!

Dealing with head lice is manageable and can be handled quite successfully via least toxic means. My recommendations are based on research into non-toxic means, and on personal experience. You should read the NPA and BIRC information for the full scoop. Keep in mind, once again, that this is not medical advice, nor is it intended to replace medical advice!

The big key is to be meticulous about the steps you take. You will be most successful if you also spend a few minutes using the BIRC and NPA resources to understand what head lice are, how they breed, how long they live, and what are their characteristics.

¹ National l Pediculosis Association, P.O. Box 610189, Neton, MA 02161. Phone: 781-449-6487. Fax: 781-449-8129. Website: http://www.headlice.org

² Bio-integral Resource Center (BIRC), P.O. Box 7414, Berkley, CA 94707. Phone: 510-524-2567.

³"Stopping Head Lice Safely." Common Sense Pest Control Quarterly (entire issue), Volume XIV: #4, Fall, 1998.

⁴Innomed Metal Lice Comb. Hogil Pharmeceuticals. Two Manhttanville Rd., Purcahse, NY 10577. Phone: 914-696-4600.

⁵Lice Meister Comb - from the NPA. Order Phone Number: 888-542-3634.

⁶ Burgess, I.F., 1995. Human lice and their management. Advances in Parasitology 36:272-341.

⁷ Mumcuoglu, K.Y. 1996. Control of human lice infestations past and present. American Entomology, Fall: 175-179.

⁸ Feldman, R.J. and H. Maibach. 1974. Percutaneous penetration of some pesticides and herbicides in man. Toxicol. Apl. Pharmacol. 28: 126.

⁹ Telch, J. and D.A. Jarvis. 1982. Acute intoxication with lindane. CMA Journal 126: 662-663.

¹⁰ Hulth, L., M. Larsson, R. Crlsson and J.E. Kihlstrom. 1976. Convulsive action of small single oral doses of the insecticide lindane. Rull.Envoron. Contam. and Toxicology 16: 133-138.

¹¹ Ginsburg, C.M., W. Lowry and J.S. Reisch. 1977. Absorption of lindane in infants and children. J. Pediactrics 91(6): 998-1000.

¹² Lee, B., P. Groth and W. Turner. 1976. Suspected reactions to gamma benzene hexachloride. JAMA 236(24):2846.

¹³ Solomon, L.M., L. Fahrner and D.P. West, 1977. Gmma benzene hexachloride toxicity. Arch. Dermatol. 113: 353-357.

¹⁴ Reuber, M.D. 1979. Carcinogenicity of lindane. Environ. Res. 19: 460-481.

¹⁵ Morgan, D.P., E.M. Stockdale, R.J. Roberts and A.W. Walter. 1980. Anemia associated with exposure to lindane. Arch. Environ. Health 35(5): 307-310.

¹⁶ Loge, J.P. 1965. Aplastic anema following exposure to benzene hexachloride. JAMA 193(2): 104-108.

¹⁷ Quarles, William, 1998. Lice and Insecticide Resistance. Commons Sense Pest Control 14 (4): 13-17.