According to an article in Today’s Pharmacist, “Pharmacists should be aware of the limitations of over-the-counter (OTC) treatments, to which lice are widely resistant.”
The latest research, published in the Journal of Medical Entomology in 2016, found that 98 percent of lice in 42 states are now resistant to pyrethroids, the class of insecticides used in the most common OTC lice products.
“Current treatment guidelines published by the American Academy of Pediatrics (AAP) mention the availability of two OTC treatments for self-treatment of head lice (permethrins and pyrethrins) but emphasize the increasing need for guidance by health care professionals in selecting treatment,” the article states. Reasons given for caution include, “OTC product misuse and repeated infestations resulting from treatment resistance and a lack of ovicidal activity with OTC products.”
Indeed, it is common for parents to overuse OTC products when they don’t work the first time. Also, as the article points out, most lice products are not “ovicidal”—they don’t kill or remove the eggs, which, if not removed, will hatch and result in a fresh infestation of head lice.
The article reads, “Although many treatments for head lice are toxic enough to kill lice immediately, treatments have varying efficacy against the eggs of head lice.” The article continues, “When eggs hatch, for many products, retreatment may be necessary to fully eradicate the infestation.”
“In addition to explaining the appropriate use of OTC treatments, pharmacists can alert patients that these treatments are often overused, are often used inappropriately in cases when there is no infestation, and have become increasingly ineffective over time due to widespread resistance.”
Pyrethroids have also been linked to health problems. One recent study linked the insecticide to premature puberty in boys; another found a link to attention deficit problems.
All of this begs the question: Why should parents use a product that doesn’t work and could be dangerous?
For parents concerned about the risks and the ineffectiveness of OTC lice treatment products, there are other, safer, more effective options. Researchers at the University of Utah developed a medical device that kills lice and eggs by dehydrating them with warm air. The device, commercialized under the name AirAllé, is FDA-cleared. Clinical trials found that the device killed live lice and more than 99 percent of eggs.
Treatment using the AirAllé device is available at hundreds of Lice Clinics of America urgent care clinics; there are more than 300 Lice Clinics of America treatment centers in 34 countries, and the clinics have together eradicated more than 500,000 cases of head lice.
Even better, treatment takes about an hour and is guaranteed to be effective.
The same Lice Clinics of America team has also developed a line of non-toxic, proven, home lice treatment products. The Lice Preventer Kit and the Lice Remover Kit each use an easy-to-apply gel and built-in applicator that can be used to prevent and remove lice, respectively. Both are also guaranteed to be effective when used as directed.