Regulating louse salons: Nit picking over regulations or just scratching the surface? - updated 27 March 2012
A contentious battle is brewing in the Golden State. This began as a NIMBY (not in my backyard) report of the planned opening of a delousing salon in Martinez, CA. Main Street business operators, residents and local politicians were said to have expressed incredulity and disapproval of this planned venture, and detractors have cited a zoning issue - the absence of a category ‘lice removal salon’ from the extensive list of permissible commercial ventures. Even the Mayor doesn’t believe such a business should operate in the downtown area. Some business managers in the area expressed fear that clients of the louse-attracting venture would somehow impart risk to them or their clientele. Now, eyebrows are being finally being raised to consider the legality of louse removal salons.
Before we discuss the salons and their activities, it is important to consider what is a head louse, and how likely is it that a person will be endowed with these villainous creatures? Head lice are tiny blood-feeding insects that infest the scalp hair solely of people. Despite the often repeated claim that ‘6-12 million’ kids are infested each year in the U.S., those numbers are without any merit and amount to gross exaggerations based upon flawed statistics. In reality, head lice are most prevalent amongst kids in the K-4th grade levels, and should, on average, be expected on just about 1 in every 100 kids of that age group. Hence, MOST kids are not infested, and most never will be ‘with lice’.
What about the eggs of lice? Female head lice affix their eggs (‘nits’) to the scalp hair of their hosts. Unless the mother louse had mated, any eggs she deposits will never give rise to another louse. Similarly, the hatched (empty) eggs from a long-extinct infestation may remain cemented to the hair for months or even years. They will merely be miniscule shiny adornments, no more significant than would be a dusting of glitter on the hair. The presence of nits on the hair, by themselves, is not a sufficient basis to proclaim a child to be infested.
Let’s be clear. Head lice may cause some annoyance, but a person with head lice is not ‘diseased’. Furthermore, head lice should not be expected to transmit any disease-causing microbe. So, being ‘with head lice’ neither is a significant health issue nor a public health matter.
Next, let’s consider the clients of these louse-removal salons. These are folks who believe that they (or more usually, their children) are infested by head lice or have been exposed to others who are so infested. Upon observing a foreign object on the hair, many parents jump to the conclusion that it must be a louse or louse egg. But, the vast majority of such sightings are made in error. Many of the moving objects are other kinds of insects (such as flies or ants) that became entrapped in the hair while walking or flying by. They pose no harm, and can easily be let loose with the flick of a finger or a stroke from a brush. The bulk of the non-movable objects are merely bits of scalp debris (e.g. dandruff, detritus, etc.). Hence, the majority of folks who seek to patronize such services are there for the wrong reasons; they (or their children) don’t have lice or louse eggs in the first place. Nonetheless, these clients patronize such services, often with the mistaken expectation that every nit or nit-like object must be removed from the hair. The presence of nits, by themselves, is NOT indicative of an ongoing infestation, and should not be the basis for treatment.
Now, what about the louse salons? What are these establishments and what do they claim to offer? These businesses range from those composed of a lone operator who may work out of her home or make house calls, to glitzy modern franchised brick and mortar storefronts that bear an uncanny resemblance to upscale beauty salons. They advertise that they provide services to inspect hair for lice and nits, to manually comb or otherwise pick these objects from the hair, and they sell and apply products that are claimed either to treat or repel lice from a person or the home environment. A few salons rely upon a reasonably effective hot air treatment from an FDA-registered device to kill lice and their eggs. Louse and nit removal salons are popping up across the country (and abroad), and may soon become as prevalent as are head louse infestations, themselves. Apart from the question as to whether or not such establishments are actually needed, state regulators should carefully examine whether these salons are even legal.
What services or products from the salons might deserve some level of regulation? Personnel that work at these establishments may touch, comb and cut hairs of their clients. Barbers and beauticians who perform similar manipulations of the hair are almost invariably licensed to do so by the state or municipality, and must demonstrate that they operate within the applicable cosmetology and sanitary codes. So, why are the owners and workers of the louse salons not required to be licensed and abide by these same health requirements? Officials from the California Department of Consumer Affairs (the agency that licenses cosmetology facilities, hair salons, barber shops and their employees) and the Department of Public Health were unaware of louse removal salons or of any regulations that might apply to louse removal salons.
Consider also other activities engaged in by personnel of the louse salons, and whether these should also be regulated. During their inspections of a person’s scalp hair, they may find what they believe is their quarry - a louse or louse egg. By proclaiming a client to be ‘with lice’, the workers there essentially are rendering a medical diagnosis. But, do they have the medical credentials to offer such a conclusion? Not likely. Then, why are they permitted to do so?
Do these workers have the expertise and equipment to identify lice and their eggs? Again, most likely they do not. IdentifyUS LLC has received countless samples from clients and workers of many such establishments, and been asked to comment upon what kind of ‘super louse’ was discovered by the salon workers. Not surprisingly, many of these objects are not lice or louse eggs, either in whole or part. Most often, these are bits of debris unrelated to lice, or are creatures of no concern.
Finally, these establishments are often found to be selling or applying diverse kinds of formulations (some knowledgeable folks might refer to these as ‘snake oils’) with astounding claims that these products will kill or repel lice or melt the eggs from the hair. On what basis do they make these claims of efficacy or safety? How is it that they can market or apply products said to kill or repel lice without being subjected to the same standards (and costs) that must be borne by companies that register their pediculicides (anti-louse products) with the FDA or EPA? The testimonials proclaiming the wonders of the salon products flow like water, but objective data are rarely, if ever, available. Hence, these establishments should be scrutinized for many reasons.
Eliminating bona fide lice from the hair certainly seems like a wise endeavor. As far as we know, head lice don’t impart any advantage to a child or adult, and they can cause annoyance to some. Efforts to remove louse eggs (or objects presumed to be nits) are frequent activities, and tend to cause much confusion and angst amongst parents and school authorities. ‘No nit’ policies are, fortunately, falling like dominoes as school and health administrators recognize the folly on which such archaic requirements were formerly based. Not surprisingly, many of those who own louse salons aggressively argue in favor for no-nits policies, and even suggest that ‘outbreaks’ or ‘epidemics’ of head lice will result without their services.
Some parents who desire to have their child(ren) rendered free of lice, nits (and debris) may lack the interest, time, physical ability or visual acuity to attend to this task. If they have the financial resources (often more than $100 per hour) to patronize these providers, and if they understand that such providers may have neither the proper credentials nor skills to attain the goal, then so be it. More troubling are those circumstances when parents feel compelled by school personnel or others to utilize the services of professional nit pickers. The most onerous scenarios arise when school administrators opt (or are strong-armed) to bring such louse- and nit-picking services into the school. What’s next, offering hair cuts, manicures, pedicures and facials within the schools? When will education stop taking a back seat to myth and marketing?
State regulators now know about these burgeoning businesses. If these businesses tread into the highly regulated worlds of medicine and of cosmetology, then they should be shut down or tested and licensed to confirm that they are proficient and abide by sanitary code requirements.
UPDATE: The Martinez Planning Commission must now decide whether the proposed louse removal salon belongs in a category with barbershops and beauty salons or in another category that would include extermination or pest removal businesses (in which case the salon would be permitted only in the Service Commercial District areas). They might also consider whether it is a medical practice. State boards that regulate medical, cosmetology, consumer services and other practices might take this opportunity to review the activities of such salons, as these establishments are likely to spread (probably faster than the lice and pockets they seek to pick).
UPDATE: The Martinez Planning Commission has now granted permission for this louse removal business to move ahead with plans to open on Main Street. Two of the Commissioners expressed their concerns of a lack of current “…oversight of the nascent lice removal salon industry, as operators do not need to get any type of license before working on customers, unlike stylists, barbers or manicurists…. “There is no oversight, there is no training, no consumer protection … I mean I could go and do it … and if someone goes in there and they have a problem, who are they going look to?” We anticipate that the Planning Commission and the State health regulators would take a dim view if a non-medical establishment sought to open their doors and offer services to inspect clients for ticks, scabies mites or pinworms, and then to remove or treat for these conditions. So, why would they turn a blind eye when it comes to head lice?
Another update (March 27, 2012): The local paper launched an online poll to gauge public opinion as to whether the city should decide what businesses - and in particular this louse removal salon - may be located near restaurants and clothing shops. This has generated a flurry of comments from folks who readily display the extent of their misinformation and biases. Still no word from those who should decide if these salons are providing a medical, pest control or cosmetology services.
The saga continues (May 3, 2012): Martinez officials have now ruled that the louse salon that planned to open on Main Street is not consistent with current code requirements. The salon owners can apply for a conditional permit, and the city council may consider amending their zoning regulations to permit such a business to operate. This still begs the issue as to whether such establishments should be regulated by health or cosmetology service providers.
Many who believe they’re dealing with head lice will benefit (and potentially save considerable funds) by viewing the information provided online by IdentifyUS LLC.