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AT-HOME LICE
TREATMENT
Presented by
Nitwit Lice Removal
Robin Wise Lofstrom
owner/operator

Seattle, Washington




ยฉ 2012
The Cetaphil Method



Lice lifecycle   FAQs             How-to




                                     Be persistent.
                                        Be patient.
                        And learn through practice.
The lice lifecycle

                            from adult
                                 to egg
                             to nymph
                     and to adult again
Adults lay 4-5
                     eggs daily.




And then mature
 adult begins to
                   Adults
                                       Nymphs emerge
 eggs, whereas
the older adults
                   live for            within 7-10 days
       die.        30 days


                   Nymphs mature
                   within 9-12 days.
adult head lice
pediculis humanus capitis
pest, not pestilence
                            โ€ข condition is called pediculosis
                            โ€ข live for 30 days
                            โ€ข feed 5 times/day on blood | pierce
                              your scalp | inject special saliva
                            โ€ข about the size of a sesame seed |
                              very light brown or grey
                            โ€ข close to the scalp | along the
                              hairline, at the crown, and behind
                              the ears
                            โ€ข repelled by light
                            โ€ข lice move by crawling only
                            โ€ข males slightly smaller
reproduction
source: Wikipedia
                    โ€ข virgin females do not reproduce
                    โ€ข malesโ€™ front 2 legs used for holding
                      the female during copulation
                    โ€ข pairing within first 10 hours | within
                      24 hours, copulation occurs
                      frequently
                    โ€ข hazards of copulation: mating lasts
                      more than 1 hour | may die within
                      a few days | older females
                      frequently die after copulation
eggs
source: Centers for Disease Control
                                      โ€ข often found in clusters | look all
                                        along the scalp
                                      โ€ข adult female secretes a glue,
                                        which quickly hardens into a
                                        sheath (similar to keratin)
                                      โ€ข .8 cm | oval shaped | tan to
                                        coffee colored when embryo is
                                        inside
                                      โ€ข eggs within ยผโ€ to ยฝโ€ inch {1 cm}
                                        are viable
                                      โ€ข require constant body heat for
                                        incubation
nits
Donโ€™t be so nitpicky!
                        โ€ข nits are not eggs
                        โ€ข nits are:
                           โ€“ hatched egg shells, still
                             attached to hair
                           โ€“ eggs containing dead
                             embryos, still attached to hair
                        โ€ข no-nit policies are misleading
                        โ€ข nits do not indicate a current
                          infestation
                        โ€ข proper identification of head lice
                          should be presence of live eggs
                          and live lice
nymphs
โ€ข emerge from their eggs within 7-
  10 days
โ€ข much smaller than mature lice
โ€ข as compared to an adult finger,
  100 nymphs could be lined up
  end-to-end
โ€ข mature within 9-12 days
โ€ข shed their exoskeleton 3 times
  before maturity
โ€ข discarded exoskeletons are often
  improperly identified as live lice
โ€ข combs rarely get nymphs
FAQs



       answers to the 8 most common questions
โ€ข   How come I didnโ€™t know I had lice until just now?
โ€ข   How thoroughly do I need to clean my house?
โ€ข   Is it true that head lice are becoming resistant to pesticides?
โ€ข   Whatโ€™s the best comb to use?
โ€ข   What about natural remedies?
โ€ข   What is the Cetaphil treatment?
โ€ข   What questions should I ask of a professional head lice
    treatment provider?
โ€ข   How do I prevent subsequent lice infestations?
Symptoms




can I have head lice and   not even know?
             The itching that sometimes accompanies lice is caused by an
             allergic reaction to their saliva, and it can take weeks for it to
                                                                    develop.
2000 US research study, reported in the Pediatric Infection Disease Journal.




are head lice ever   misdiagnosed?
       In a 2000 study, only 31% of the specimens submitted for a research
               study by physicians, parents, and teachers were actually lice.
                   35% were simple debris, such as dandruff, scabs, or dirt.
what informs my   healthcare provider?
             Healthcare professionals may rely more on past practices and
                                                                       norms.
         As professionals, they may distrust clinical research trials solicited
                      by manufacturers, which are clearly driven by profit
Simple common sense




how do I   clean my house?
           Housekeeping tasks should be simple to do and take little time.
                      Lice do not live longer than 48 hours off their host.
                       It is far more important to treat headsโ€”not beds.
Simple common sense




do I have to   bag everything?
                   If you choose to bag things up, 48-72 hours is sufficient.
         One cycle in the dryer is enough for washable and dryable fabrics.
              Lay sheets over upholstered items, and swap out for 3 days.
Pesticides can be very unsafe!




are head lice   resistant to pesticides?
                    Many families use pesticides one, even twice, to no avail.
                In addition to their health risks and bothersome side effects,
                                    pesticides require multiple re-treatments.
                     Follow the instructions exactly, and consult your doctor.
Lindane requires a prescription from your doctor.




what about   lindane (Kwell)?
         Lindane should only be used if all other treatments have failed.
        While the patient needs to keep it on for 8 hours, you must wear
                                              disposable gloves to apply.
                                                               Not good.
Like all commercial products, Nix is only partially effective at killing eggs.




what about   permethrin (Nix)?
                                     Nix is an over-the-counter product,
                                which attacks the nervous system of lice.
                              Lice become paralyzed and eventually die.
Pesticides can be very unsafe!




what about   malathion?
                               Malathion requires a doctorโ€™s prescription.
        Besides side effects and inherent risks, it is also highly flammable.
Pesticides can be very unsafe!




what about   Natroba?
                            Natroba was recently approved by the FDA.
                           Like malathion, Natroba is highly flammable.
         It is not recommended for children younger than 4 years of age.
These include LiceMeister, RobiComb, Terminator, and more.




is   combing sufficient?
         Combing may be sufficient, depending upon severity of infestation.
      Beyond the amount of time it takes to comb through the hair (which is
     extensive, to be repeated almost daily), the fact is that any combโ€”even
                those with the finest teethโ€”rarely get every nymph and egg.
Demonstration



           How to perform a head check.
Head checks
These are commonly called โ€œsuffocants.โ€




how about   olive oil or mayonnaise?
   These products act as suffocants, and are intended to plug the breathing
                                                               holes of lice.
                  Any movement of the head, however, can dislodge them.
                  And lice are known to hold their breath for up to 6 hours.
See the research paper by Deon Canyon, University of Hawaii.




how about   tea tree oil, mint, etc.?
   There is no scientific research which proves the effectiveness of repellents
            They canโ€™t hurt โ€“ but they are not a reliable means of prevention.
     The most effective way to treat head lice is through education, training,
                                                          and practiceโ€”yours.
Also called the โ€œNuvo method.โ€




what is the   Cetaphil treatment?
   Cetaphil is a gentle liquid soap, recommended as a daily facial cleanser by
                                 dermatologists for people with sensitive skin.
Cetaphil acts as a suffocant.




how does the   Cetaphil work?
         Cetaphil is applied liberally to the hair, and then completely dried.
                    Any live lice become trapped between soap and strand.
                    The lice become entombed, and suffocate 8 hours later.
Cetaphil acts as a suffocant.




Why do you need to repeat      repeat Cetaphil?
           Cetaphil re-application is intended to interrupt the lice lifecycle.
                               Both reapplications are spaced 7 days apart,
                  allowing nymphs a chance to grow large enough to trap.
Demonstration



        How to perform a Cetaphil treatment.
Cetaphil treatment
And when is a guarantee not a guarantee?




what should i ask a   treatment provider?
                           Lice treatment is a booming and lucrative business.
       There are many providers to choose from, including smaller operators,
    large salons, and those who rely on commercial products and equipment.
what is the   Shepherd method?
     The Shepherd method is a wet-head combing, followed by a headcheck.
                            Providers who claim to be certified in this method.
     The certifying body is Lice Solutions Resource Network, based in Florida,
                                              which is structured as a 501( c)3.
who will treat you and your family?
                  If you hire a salon, consider how they conduct business.
     Salons who operate on a high volume may not offer you a great value.
  Employees without a good wage and regular hours may not be invested in
                                                       their workโ€”or you.
how does your   guarantee work?
         If you are expected to return in order to validate their guarantee,
                        calculate the cost of a return visit in terms of time.
                        If you cannot return on time, what happens then?
how   long is their guarantee?
      If their guarantee is valid for one or two weeks only, remember that two
                       nymphs left behind will have already been reproducing.
                                          And new nymphs will still be emerging.
what if they were not
successful?
    Find out what happens if you discover you still have lice after their
                                                guarantee has ended.
                             This may represent a hidden cost to you.
how much   will it cost?
                                       Plan on at least 90 minutes per head.
                                Calculate the cost of travel in your total cost.
    If they cannot treat you at your convenience, calculate how long you or
                           your family will be absent from work and school.
can I   prevent head lice?
     Encourage your children to never share hats, headwear, headbands, etc.
   The most effective way to prevent head lice is to be vigilant by performing
                                                          regular head checks.
Nitwit Lice Removal
206-327-5782
www.nitwitseattle.com
because someoneโ€™s gotta do it!




                          Seattleโ€™s only at-home lice treatment provider.
         Independently owned and operated, with 7 years of experience.
 Offering a unique 30-day guarantee that pays you to be lice-free. Really.

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Lice education & training

  • 2. Presented by Nitwit Lice Removal Robin Wise Lofstrom owner/operator Seattle, Washington ยฉ 2012
  • 3. The Cetaphil Method Lice lifecycle FAQs How-to Be persistent. Be patient. And learn through practice.
  • 4. The lice lifecycle from adult to egg to nymph and to adult again
  • 5. Adults lay 4-5 eggs daily. And then mature adult begins to Adults Nymphs emerge eggs, whereas the older adults live for within 7-10 days die. 30 days Nymphs mature within 9-12 days.
  • 6. adult head lice pediculis humanus capitis pest, not pestilence โ€ข condition is called pediculosis โ€ข live for 30 days โ€ข feed 5 times/day on blood | pierce your scalp | inject special saliva โ€ข about the size of a sesame seed | very light brown or grey โ€ข close to the scalp | along the hairline, at the crown, and behind the ears โ€ข repelled by light โ€ข lice move by crawling only โ€ข males slightly smaller
  • 7. reproduction source: Wikipedia โ€ข virgin females do not reproduce โ€ข malesโ€™ front 2 legs used for holding the female during copulation โ€ข pairing within first 10 hours | within 24 hours, copulation occurs frequently โ€ข hazards of copulation: mating lasts more than 1 hour | may die within a few days | older females frequently die after copulation
  • 8. eggs source: Centers for Disease Control โ€ข often found in clusters | look all along the scalp โ€ข adult female secretes a glue, which quickly hardens into a sheath (similar to keratin) โ€ข .8 cm | oval shaped | tan to coffee colored when embryo is inside โ€ข eggs within ยผโ€ to ยฝโ€ inch {1 cm} are viable โ€ข require constant body heat for incubation
  • 9. nits Donโ€™t be so nitpicky! โ€ข nits are not eggs โ€ข nits are: โ€“ hatched egg shells, still attached to hair โ€“ eggs containing dead embryos, still attached to hair โ€ข no-nit policies are misleading โ€ข nits do not indicate a current infestation โ€ข proper identification of head lice should be presence of live eggs and live lice
  • 10. nymphs โ€ข emerge from their eggs within 7- 10 days โ€ข much smaller than mature lice โ€ข as compared to an adult finger, 100 nymphs could be lined up end-to-end โ€ข mature within 9-12 days โ€ข shed their exoskeleton 3 times before maturity โ€ข discarded exoskeletons are often improperly identified as live lice โ€ข combs rarely get nymphs
  • 11. FAQs answers to the 8 most common questions
  • 12. โ€ข How come I didnโ€™t know I had lice until just now? โ€ข How thoroughly do I need to clean my house? โ€ข Is it true that head lice are becoming resistant to pesticides? โ€ข Whatโ€™s the best comb to use? โ€ข What about natural remedies? โ€ข What is the Cetaphil treatment? โ€ข What questions should I ask of a professional head lice treatment provider? โ€ข How do I prevent subsequent lice infestations?
  • 13. Symptoms can I have head lice and not even know? The itching that sometimes accompanies lice is caused by an allergic reaction to their saliva, and it can take weeks for it to develop.
  • 14. 2000 US research study, reported in the Pediatric Infection Disease Journal. are head lice ever misdiagnosed? In a 2000 study, only 31% of the specimens submitted for a research study by physicians, parents, and teachers were actually lice. 35% were simple debris, such as dandruff, scabs, or dirt.
  • 15. what informs my healthcare provider? Healthcare professionals may rely more on past practices and norms. As professionals, they may distrust clinical research trials solicited by manufacturers, which are clearly driven by profit
  • 16. Simple common sense how do I clean my house? Housekeeping tasks should be simple to do and take little time. Lice do not live longer than 48 hours off their host. It is far more important to treat headsโ€”not beds.
  • 17. Simple common sense do I have to bag everything? If you choose to bag things up, 48-72 hours is sufficient. One cycle in the dryer is enough for washable and dryable fabrics. Lay sheets over upholstered items, and swap out for 3 days.
  • 18. Pesticides can be very unsafe! are head lice resistant to pesticides? Many families use pesticides one, even twice, to no avail. In addition to their health risks and bothersome side effects, pesticides require multiple re-treatments. Follow the instructions exactly, and consult your doctor.
  • 19. Lindane requires a prescription from your doctor. what about lindane (Kwell)? Lindane should only be used if all other treatments have failed. While the patient needs to keep it on for 8 hours, you must wear disposable gloves to apply. Not good.
  • 20. Like all commercial products, Nix is only partially effective at killing eggs. what about permethrin (Nix)? Nix is an over-the-counter product, which attacks the nervous system of lice. Lice become paralyzed and eventually die.
  • 21. Pesticides can be very unsafe! what about malathion? Malathion requires a doctorโ€™s prescription. Besides side effects and inherent risks, it is also highly flammable.
  • 22. Pesticides can be very unsafe! what about Natroba? Natroba was recently approved by the FDA. Like malathion, Natroba is highly flammable. It is not recommended for children younger than 4 years of age.
  • 23. These include LiceMeister, RobiComb, Terminator, and more. is combing sufficient? Combing may be sufficient, depending upon severity of infestation. Beyond the amount of time it takes to comb through the hair (which is extensive, to be repeated almost daily), the fact is that any combโ€”even those with the finest teethโ€”rarely get every nymph and egg.
  • 24. Demonstration How to perform a head check.
  • 26. These are commonly called โ€œsuffocants.โ€ how about olive oil or mayonnaise? These products act as suffocants, and are intended to plug the breathing holes of lice. Any movement of the head, however, can dislodge them. And lice are known to hold their breath for up to 6 hours.
  • 27. See the research paper by Deon Canyon, University of Hawaii. how about tea tree oil, mint, etc.? There is no scientific research which proves the effectiveness of repellents They canโ€™t hurt โ€“ but they are not a reliable means of prevention. The most effective way to treat head lice is through education, training, and practiceโ€”yours.
  • 28. Also called the โ€œNuvo method.โ€ what is the Cetaphil treatment? Cetaphil is a gentle liquid soap, recommended as a daily facial cleanser by dermatologists for people with sensitive skin.
  • 29. Cetaphil acts as a suffocant. how does the Cetaphil work? Cetaphil is applied liberally to the hair, and then completely dried. Any live lice become trapped between soap and strand. The lice become entombed, and suffocate 8 hours later.
  • 30. Cetaphil acts as a suffocant. Why do you need to repeat repeat Cetaphil? Cetaphil re-application is intended to interrupt the lice lifecycle. Both reapplications are spaced 7 days apart, allowing nymphs a chance to grow large enough to trap.
  • 31. Demonstration How to perform a Cetaphil treatment.
  • 33. And when is a guarantee not a guarantee? what should i ask a treatment provider? Lice treatment is a booming and lucrative business. There are many providers to choose from, including smaller operators, large salons, and those who rely on commercial products and equipment.
  • 34. what is the Shepherd method? The Shepherd method is a wet-head combing, followed by a headcheck. Providers who claim to be certified in this method. The certifying body is Lice Solutions Resource Network, based in Florida, which is structured as a 501( c)3.
  • 35. who will treat you and your family? If you hire a salon, consider how they conduct business. Salons who operate on a high volume may not offer you a great value. Employees without a good wage and regular hours may not be invested in their workโ€”or you.
  • 36. how does your guarantee work? If you are expected to return in order to validate their guarantee, calculate the cost of a return visit in terms of time. If you cannot return on time, what happens then?
  • 37. how long is their guarantee? If their guarantee is valid for one or two weeks only, remember that two nymphs left behind will have already been reproducing. And new nymphs will still be emerging.
  • 38. what if they were not successful? Find out what happens if you discover you still have lice after their guarantee has ended. This may represent a hidden cost to you.
  • 39. how much will it cost? Plan on at least 90 minutes per head. Calculate the cost of travel in your total cost. If they cannot treat you at your convenience, calculate how long you or your family will be absent from work and school.
  • 40. can I prevent head lice? Encourage your children to never share hats, headwear, headbands, etc. The most effective way to prevent head lice is to be vigilant by performing regular head checks.
  • 41. Nitwit Lice Removal 206-327-5782 www.nitwitseattle.com because someoneโ€™s gotta do it! Seattleโ€™s only at-home lice treatment provider. Independently owned and operated, with 7 years of experience. Offering a unique 30-day guarantee that pays you to be lice-free. Really.

Editor's Notes

  1. This presentation demonstrates the new capabilities of PowerPoint and it is best viewed in Slide Show. These slides are designed to give you great ideas for the presentations youโ€™ll create in PowerPoint 2010!For more sample templates, click the File tab, and then on the New tab, click Sample Templates.
  2. Lice โ€“ what a great big drag. I remember โ€“ very well โ€“ the first time my three kids got lice, back when they were only 8, 5, and 2. Now, five years later, Iโ€™ve started my own small business in a niche market, and Iโ€™ve had a lot of practice at doing what I do. The first time you or your family gets lice is terrible. Thereโ€™s too much conflicting advice, too many treatment options, and too few hours in a day. And you just know itโ€™s going to cost you! Itโ€™s enough to make you tear your hair out! But this short tutorial will help you, and it only takes 6 minutes.
  3. When treating head lice, the most effective thing you can do is to be persistent, be patient, and practice.What weโ€™re going to do is quickly review lice biology, run through the most common questions related to head lice, and then Iโ€™m going to demonstrate how to look for lice. My preferred method for lice treatment is whatโ€™s called the Cetaphil treatment, and weโ€™re going to talk about that, too.
  4. Okay: So letโ€™s talk about Louse Biology 101.The lice lifecycle takes us from adult to egg to nymph and then back to adult.Nymphs are like the teenagers in the lice world.
  5. An adult head lice has a lifecycle of 30 days, and during that time, the female can lay up to 4-5 eggs each day. Eggs hatch with 7-10 days, and what emerges is called a nymph.It only takes 9-12 days for nymphs to mature into an adult.And once they are mature, they begin to lay eggs.
  6. Adult head cause a condition called pediculosis, which affects something like 9-12 million people in the US alone. As we have already seen, they live for about 30 days.And they need to eat five square meals a day. These are blood-sucking pests that pierce your scalp with their claws, injecting a special saliva to clot your blood.Theyโ€™re just about the size of a sesame seed, and are either very light brown or somewhat grey, depending on whether theyโ€™re eaten recently.Despite what you may have heard, lice can be found absolutely anywhere along the head, and so can their eggs. But their favorite spots tend to be all along the hair line, at the crown, and behind the ears. When I check people for lice, I bring along a special light which helps me to find lice in two ways: first of all, without that light, I doubt Iโ€™d see their eggs, and secondly, with that light, the lice try to move away from me โ€“ and itโ€™s far easier for me to see something moving. But when they move, they move quickly; if you see something moving, track it carefully and donโ€™t lose sight of it.Because of their specialized claws, theyโ€™re not suited for crawling on flat surfaces, and without wings, they cannot fly. These are crawling insects that are adapted for attaching themselves to human hair.
  7. Only a female who has already copulated can lay an egg. To grasp her firmly, the male has a pair of specialized front legs.Within 10 hours of maturity, they can begin to copulate.Within 25 hours, copulation begins to occur frequently.Luckily for us, copulation can kill her! Mating lasts up to an hour, and sometimes the femaleโ€™s body is ripped apart. Mating occurs so frequently that the female may die within just a few days, and older females frequently die after copulation. So just because you have head lice doesnโ€™t mean you have a head full of healthy, hardy, happy lice. At least thereโ€™s that. Right?
  8. Eggs are often found in clusters โ€“ if you find one, look closely around that same area. Youโ€™ll be looking for eggs everywhere, but start behind the ears, first. Lice love laying eggs there. If you find what you think is an egg, but it easily moves, then keep looking. Eggs are pretty well cemented to the hair strand โ€“ they donโ€™t fall off, they have to be pulled off.If you find something thatโ€™s clear or white, thatโ€™s a nit. And nits are not eggs. Weโ€™ll talk more about that in a minute.Eggs are darker than nits, because thereโ€™s a living creature inside and it has a body, and blood. Eggs within ยผโ€ to ยฝโ€ from the scalp are viable, and what keeps them viable is your body heat. The further away from the scalp they are, the less viable they are. This is a good time to mention the chicken-and-the-egg analogy: chickens lay eggs, and lice lay eggs. They both need nests to incubate their embryos. Without incubation, the embryo will die inside the shell. With incubation, the embryo emerges, and the egg shell stays behind.
  9. There is a distinction between eggs and nits: Eggs are viable. Nits are not. Eggs are viable, nits are not.Nits are defined as the egg shells left behind (but still attached), or the eggs which are no longer viable, and which contain dead embryos.Nits are nothing to worry about, although most people remove them because of perceptions of hygiene.Families with children in school, however remove them because of no-nit policies, which is a shame.Nits do not indicate a current infestation; they only indicate that the child has HAD lice, not that the child HAS lice. The American Academy of Pediatrics agrees.To properly diagnose head lice, only the presence of live lice and viable eggs counts.
  10. Nymphs emerge from their eggs within 7-10 days.And they are ridiculously small. TWhen the nymphs are newly born, their ratio to an adult finger is something like 100:1They grow incrementally larger over 9-12 days, shedding their exoskeletons three times. Sometimes, this shedding kills them, if they do not fully emerge from the shell.Discarded exoskeletons are often identified as live lice.Combs rarely get every nymph, no matter how fine the combโ€™s teeth are. It only takes one male and one female nymph to start the cycle all over again.If you see something on the scalp which looks like a clear, somewhat shapeless blob with a dark pinprick in the middle โ€“ thatโ€™s the nymph. Really take your time here, and double or triple check that you actually removed the nymph.
  11. Now weโ€™re going to answer the 8 most common questions about lice. And they are as follows:
  12. This is by far the most common question I hear: How could we have had lice and not even known? Iโ€™m sorry to tell you this, but it can take weeks to develop itching.Itching is caused by an allergic reaction to the liceโ€™s saliva, which was used to clot your blood.Itโ€™s a bit like cats: youโ€™re not allergic to cats โ€“ youโ€™re allergic to their saliva. Most people do, however, notice the tickling sensation of something crawling on their head.I treated a 20 year old student once, who had had lice for about a year, and she had no idea.