From Our 2012 Archives
New Treatment May Kill Head Lice -- Fast
Reviewed by Louise Chang, MD
Oct. 31, 2012 -- Parents dread getting the call or the memo in a child's backpack: the one telling you that your child or one of his or her classmates has head lice. Now, there's a new option in pharmacies that might just make that note less dreadful.
The prescription lotion Sklice (ivermectin) may safely knock out head lice in one 10-minute, comb-free treatment, according to a new study supported by Sklice manufacturer Topaz Pharmaceuticals, now Sanofi Pasteur. The findings appears in New England Journal of Medicine.
"Head lice infestation is something that has a huge social stigma and can be quite rampant, particularly when school starts in the fall," says researcher David M. Pariser, MD. He is a dermatologist of Eastern Virginia Medical School in Norfolk.
There are a number of lice treatments available today, including off-the-shelf or prescription lotions or shampoos. But they kill lice, not their eggs (nits). So, it may be necessary to repeat the treatments to get rid of newly hatched lice.
There are also salons and services that come to your home and do all the dirty work for you.
Many Lice Treatments Not All That Effective
These treatments work about 50% of the time, Pariser says. This means that they are repeated frequently, which adds to the risk of resistance.
"Ivermectin is a one-time, one-application treatment that leaves the hair nice when you are done so it is not all goopy and messy." The lotion is available by prescription and can cost up to $300 if it is not covered by insurance, he says.
There were few side effects seen in the study -- namely redness and itching. Also, the study doesn't compare Sklice to other available treatments.
Of 765 people aged 6 months and older with lice, those who used the new lotion were more likely to be louse-free by day 2, day 8, and day 15 than their counterparts who used the exact same lotion minus the active ingredient. "You need to have a treatment discussion with your doctor," Pariser says.
In an accompanying editorial, two French dermatologists write that the new lotion should be the last choice unless and until there are studies comparing it with existing treatments. They suggest following the guidelines set by the American Academy of Pediatrics in 2010. These state that off-the-shelf products such as permethrin (like Nix) or pyrethrins (like A-200, Clear Lice System, Pronto, R & C, and Rid) should be tried first.
Michele Green, MD, is a dermatologist at Lenox Hill Hospital in New York City and a mother. She is excited about the new lice treatment option. "Lice are a huge problem that nobody wants to talk about and resistance is scary," she says. "If my kids get lice this year, this is what I will use as the first line."
Ana Duarte, MD, agrees. She is director of pediatric dermatology at Miami Children's Hospital.
The new treatment "shows a lot of promise and it is exciting to have another option," she says. Regardless of which treatment you choose, "if someone in your family gets lice, everyone needs to be treated and everything needs to be washed," Duarte says.
Also, clothing, bedding, and towels should be machine washed in hot water (130 degrees) and machine dried at a high heat setting. Clothes or other items that can't be washed can be dry cleaned or stored in a sealed, plastic bag for two weeks. Combs and brushes can be disinfected by soaking in hot water (at least 130 degrees) for 5-10 minutes.
SOURCES:David M. Pariser, MD, dermatologist, Eastern Virginia Medical School, Norfolk.Pariser DM, et al. New England Journal of Medicine. 2012.367:1687-1693.Michele Green, MD, dermatologist, Lenox Hill Hospital, New York City.Chosidow I, Giraydeau B. New England Journal of Medicine. 2012.367:1750-1751 . Ana Duarte, MD, director of pediatric dermatology, Miami Children's Hospital, Miami.
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