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Magic Cure for Head Lice?

This morning, I took my 8 year old to the pediatrician as she was complaining of a headache, earache, sore throat and stomach ache.  She had an ear infection that required antibiotics.  I had a philosophical conversation with our pediatrician about prescribing such because we’d been in on Tuesday for the same complaints and at that time, she tested negative for strep and did not have an ear infection. We therefore did not receive a prescription for an antibiotic then and I queried our pediatrician about perhaps having written the prescription so I could retain it in the event that my daughter did get worse (as she did.)  He explained, “Pediatricians do not just give prescriptions for unnecessary medications.”

Well, that may be true of my daughter’s pediatrician and many many others but in the past couple of weeks, we have encountered three situations in which it appears other pediatricians/pediatric practices did not adhere to the same philosophy with respect to head lice.  I’m including all the details here in this long post in the event that you encounter a similar situation in the future.

ONE:

One of our partner day/early care environments had a small outbreak of head lice in its toddler room and its infant room.  We treated several 2 and 3 year olds plus a couple of 10 month olds using very specific non-toxic products and all natural/manual methods (and with the fine hair that the babies have, it was really more about the manual methods) earlier in the week.  However, one family (of a 7-month old) had to take its baby (identified at the daycare with head lice) to the pediatrician for a suspected ear infection so they also asked about a head lice cure.  They were advised to use an over the counter product (Rid or Nix) and were given a prescription for ivermectin pills.

The studies thus far on oral ivermectin have been in comparison to Malathion, a known-toxic lotion, but there have been no long term studies of the effectiveness of oral ivermectin (a drug used to treat scabies, roundworm and other intestinal parasites in animals and humans) for the treatment of head lice.  It is also NOT ovicidal (i.e. it does not kill the nits so continuing treatment may be required.)  Additionally, ivermectin has been indicated for the treatment of RESISTANT head lice (and not as a first course solution) in children over 30 pounds (and certainly not a 7 month old).  Given my daughter’s pediatrician’s contention that, “Pediatricians do not just give prescriptions for unnecessary medications,” we are confused by the course of action suggested by this client’s pediatrician.  (By the way, today, we treated the beautiful baby as nits were still on her hair, and the school has a no nit policy.  This is an issue with the application of any product that does not also include manual nit removal with a good lice comb or by hand.)

Finally, every single day, we see children who have been treated with the over the counter products.   Some of them present with raw and sensitive scalps, many have hair breakage and other irritations and they STILL HAVE ACTIVE cases of head lice.  There have been many reports challenging the effectiveness of these products because the lice are becoming resistant to them, and despite the fact that they’re generally the recommendation for “first attack” against head lice by medical professionals, I’m going to be bold here and express my disagreement.  I maintain there are non-toxic and effective methods for head lice removal including both professional head lice removal services and products and tools for utilization/self-treatment at home.

TWO:

A couple of weeks ago, I received urgent texts from a mother of two school-aged children whom the mother had been treating for head lice with Bactrim, prescribed by their pediatrician.  Bactrim is an oral medication used to treat varying bacterial infections.  It is not customary to have it prescribed for the eradication of head lice (under the theory that it gets into a patient’s bloodstream and  functions as a systemic poison, killing the bugs taking blood meals) and use of it might possibly lead to resistance (of Bactrim in the future.)   It is also NOT ovicidal (so the nits still need to be removed manually.)  The mother indicated that she considered the case resistant (and had existed since the end of May) but that she had not attempted other methods of removal before the Bactrim.  She requested that we head check her children to ensure all the head lice were gone.  One of her daughters had been experiencing weeks of prolonged diarrhea, attributed to the Bactrim.  We thoroughly head checked these girls who had long and thick hair and found absolutely no evidence of head lice.  No casings, no non-viable nits, no errant nits and no live bugs.  It is our opinion that it was highly unlikely that these girls had head lice before they began to take the Bactrim and therefore, the drug was unnecessary.

THREE:

Yesterday, we treated the granddaughter of a prominent local pediatrician.   His grandchild was visiting from out of town and her mother informed the grandparents that head lice had been detected on the girl’s siblings at home, and the mom wanted her daughter to be head lice free before returning home.

The pediatrician had his wife use an over the counter product on their grandchild.  The grandmother advised me that she’d found absolutely nothing on comb through and did not think that the child had head lice.

However, the mother insisted (from afar) that the child be professionally assessed.

We head checked her, found evidence and treated her, finding about 20 viable nits.  There were no live bugs (which might have been removed by the grandmother the night before but she did not see them.)

In discussing the situation with the doctor, despite the evidence in front of him (he sat in the armchair in the room while we were treating his grandchild), he appeared non-convinced of the effectiveness of the over the counter products.  Then, as I find many “scientific types” do, he questioned with curiosity, “What is the right way to treat then?”  I mentioned that there were options for “home treaters” which included non-toxic topical prescription lotions (about which he admittedly had absolutely no knowledge) but that the key to proper removal, short of using a professional service, was a thorough daily combing for a full life cycle (two weeks) with a premier head lice comb.  He said he thought Lindane an option and I disagreed (as Lindane, a toxic product, has been banned in agricultural use by the EPA, in pharmaceutical use in California and is known to potentially cause seizures and other adverse effects.)

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Head lice are so far down on the “food chain” for our pediatricians and other medical professionals who have an enormous breadth of knowledge about so many ailments, illnesses and situations presented to them.  The “head lice market” is considered ripe as cases of head lice appear to be increasing, and there are new products and treatment options available all the time.  Head lice pose absolutely no known health risk and are truly just a nuisance, but it is important to know that:

  • Treatment of head lice with over the counter products is not usually effective and unless instructions are followed to the letter, can be unsafe.
  • Before applying toxic/chemical-based prescription products to an individual’s head or giving oral medications to him/her for the treatment of head lice, we maintain that all other methods should be attempted/exhausted.  If a medical professional suggests one of these prescriptions as a first course action for head lice, request something else (including non-toxic products.)
  • There is no shortcut (other than the use of a professional service) for complete head lice removal, and the use of most products still requires a daily combing with a premier comb to completely remove all evidence (for two to three weeks.)
  • NEVER TREAT a case of head lice until it is confirmed.  Professional services exist in many markets and for a nominal fee (less than the cost of the over the counter products, in any event), a definitive diagnosis can be made with a quick and painless head lice check.

Elimilice is available to help in our facilities or in your home.  Please feel free to contact us.