The Kid’s Doctor: Lice is tough to treat

The Kid’s Doctor: Lice is tough to treat

By Sue Hubbard, M.D.,

What are kids bringing home from school besides their homework? Lice! The good news is that lice are obligate parasites and they don’t jump or fly. They are transmitted by direct contact. But, the smart ones have found another way to drive parents crazy … they are becoming more and more resistant to over-the-counter products containing permethrin.

A recent study has shown that 25 states have a big problem with lice and permethrin resistance. It seems that the lice are smart and they have developed “genetic mutations” that make them drug resistant. Texas has had a problem for several years, and I have had many patients coming into the office with bags full of “stuff” that they have used to treat their children’s head lice to no avail. Many a mother has told me she is ready to try anything … including some things that might be considered unsafe, but you know a desperate mother.

While about 12 million children a year get head lice, the louse itself does not cause any disease; just uncomfortable itching. Parents spend multi millions of dollars each year trying to eradicate head lice. In states like Texas, California, Florida and Virginia the lice are immune to over-the-counter products, while in New York, New Jersey and several other states they are partially resistant.

But don’t despair. Despite the resistance to the over-the-counter products such as Nix, there are other prescription products available. Products such as benzyl alcohol (Ulesfia), ivermectin (Sklice), malathion (Ovide) and spinosad (Natroba) may all be used to treat a case of head lice, but will require a prescription to obtain them. Although prescription drugs typically are more expensive, treating head lice with an over-the-counter product may be an exercise in futility. It is likely to be more cost- and time-effective to start with a prescription product if you live in one of the 25 states that has shown drug resistance.

So if you get a note from school that your child has head lice, pick up the phone and call your doctor’s office to seek advice on treatment.

(Dr. Sue Hubbard is an award-winning pediatrician, medical editor and media host. “The Kid’s Doctor” TV feature can be seen on more than 90 stations across the U.S. Submit questions at The Kid’s Doctor e-book, “Tattoos to Texting: Parenting Today’s Teen,” is now available from Amazon and other e-book vendors.)