Summary of Some Common Lice Prescription Medications - July 2016

When I get frantic lice calls from parents wanting to make appointments, one of the first questions I am asked, is “what should we do until you get here?” The next question is usually, “should we go to the drugstore and purchase an OTC treatment before you get to our home?” The answer to the first question we give is to take a deep breath and relax. The answer to the next question is a big NO. We usually get a response of “really? why not?” and that takes a bit of explaining.

There are a lot of different of products out there that are available to the consumer over the counter. Some are the generic drug store brand or super market brand and some are the brand names. Most over the counter products contain either Pyrethrin or Permethrin.

Pyrethrins are natural extracts from the chrysanthemum flower. Pyrethrins only kill crawling lice but are only are about 70% effective and do NOT kill unhatched nits. A second treatment is recommended in seven to 10 days to kill any newly hatched lice. Treatment failures are common and so is irritated scalp and skin.

Permethrins are similar to natural pyrethrins. Permethrins are only about 70% effective at killing live lice and do NOT kill unhatched nits. A second treatment may be necessary in seven to 10 days to kill any newly hatched lice that may have hatched after residual medication from the first treatment was no longer active. Treatment failures are also common. There has been much resistance to these medications with lice due to misuse and overuse by parents over the years. Many feel the need to “over treat” when they still are seeing live lice in addition to feeling the need to treat family members even if no “active live lice” are seen. They do this for preventative measures. To make matters even worse, "super lice" have developed a resistance to both of these pesticide treatments in the state of Washington.

I might point out that these types of "organophosphate pesticides" are being researched since childhood exposure has a possibility of causing some chronic health problems (ADHD) from multiple exposures. (Academy of Pediatrics, June 2010, "ADHD/Hyperactivity Disorder and Urinary Metabolites of Organophosphate Pesticides")

In addition, the plastic combs that come inside these kits are less than adequate to comb out all the lice and nits (eggs). This causes a lot of stress on the hair and on the child, making them feel uncomfortable. Furthermore, often times the pesticides in these treatments irritate the scalp…a lot. By the time the children and adults alike come to see me, their heads have been through so much that they do indeed hurt. It may be better all the way around if you just call me when you learn of an infestation to avoid this wasted time and expense while the infestation continues.

I also get asked questions regarding doctor prescribed prescriptions that kill both lice and their eggs. If it were me, I would think twice about putting any chemicals on my kid's head. There are still many unknown risks associated with prescription medications (many of which are classified as pesticides by the FDA). You always want to check with your child's pediatrician. Here are the most common prescribed medications:

Ules____*: Claims to kill live lice but NOT their eggs (thus still requiring manual nit removal). COST: $140 for 7 oz.

Lyc____*: Claims to kill live lice and SOME eggs (thus still requiring manual nit removal) COST: $190 for 3.4 oz.

Skl____*: Claims to kill live lice but NOT their eggs (thus still requiring manual nit removal) COST: $300 for 4 oz.

Kwe____*: Claims to kill lice and eggs, however it is banned in California due to its neurotoxicity and being possibly carcinogenic. Reports of seizures and death with improper use (carries a black box warning). Cost: $120 for 2 oz.

Ovi____*: Can only be used on kids 6 years old and up. Highly flammable - side effects include second degree chemical burns (this product is the insecticide malathion)! There is a warning that the pesticide has the risk of transdermal absorption. COST: $ 210 for

2 oz. PLEASE read drug precautions on-line before attempting to use this medication.

I believe nothing is more effective than combing with a metal, mini-grooved lice comb. When you use a professional grade lice and nit comb and practice proper methods of combing, you can and will get rid of lice (but you must followup the combing with precision manual removal of the remaining nits cemented to the hair shaft in order to prevent re-infestation). The eradication of lice is a process and one that takes time and patience since there are no shortcuts. Just call me if you don't have the time to tackle the problem by yourself!

Lice is a 4 letter word:

L is for Lice, I is for Information, C is for Control and E is for Education and that is what I want to provide for you.

Do not hesitate to call me in your hour of need!

Joan Berkowitz

(509) 714-3123

* Unable to spell complete brand name due to licensing limitations.

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