Parent Plus: Over-the-counter medications still first-line lice-fighting strategy

Many parents cringe at the word lice. So when the term “super lice” made its way into headlines this past year, it raised eyebrows among parents who find the tiny creatures a bit creepy.

News reports sounded an alarm that lice were resistant to insecticides in over-the-counter (OTC) treatments in some states, which means the treatments did not work. They suggested newer prescription products with different chemicals might work better. That left some people scratching their heads.

Resistance to common lice treatments is nothing new, said Cynthia D. Devore, M.D., FAAP, a pediatrician who helped write the American Academy of Pediatrics’ (AAP’s) report on lice.

“These so-called super-lice apparently are not a new type of lice,” Dr. Devore said, “but simply lice that may have developed genetic changes to resist treatment with the currently used over-the-counter insecticides.”

The AAP continues to recommend that families talk with their pediatrician about treatment options if their child gets head lice, she said.

Ideally, treatment should be safe, free of toxic chemicals, easy to get without a prescription, easy to use, effective and affordable, according to the AAP.

OTC medicines like permethrin 1% or pyrethrins often still can get rid of lice. Sometimes, however, these remedies may not work for some people and in some communities.

If your pediatrician believes common, safe and affordable OTC medications for head lice won’t work in your community, your child may need a newer prescription medication, Dr. Devore said.

Parents should follow the directions on the medicine exactly as written. With some products, follow-up treatments are needed seven to 10 days after the first treatment. After the treatments, parents may remove nits with a fine-tooth comb on damp hair, but the AAP does not believe children with head lice need to stay home from school.

The AAP also doesn’t recommend home remedies because there have not been enough studies showing that they work.

Resources:

• Information for parents on lice myths
• Information for clinicians - AAP clinical report "Head Lice"
• Healthy Children Radio: Head Lice