The Prescriber’s Letter published by the Therapeutic Research Center and distributed to physicians and pharmacists, is one of the most widely read and respected health newsletters. In the March 1997 issue, the Prescriber’s Letter had this to say about head lice:
- You’ll see some unusual treatments for head lice… especially for persistent cases.
- Many parents complain about treatment failures with Nix® and other products.
- Researchers are starting to suspect resistance.
- Some physicians are resorting to new therapies… but this is causing LOTS of controversy.
For example, some recommend leaving Nix® on for 4 to 8 HOURS … instead of 10 minutes. Sometimes even overnight under a shower cap. Or they prescribe Elimite® cream for head lice … and leave it on overnight too. Elimite® is five times stronger than Nix® … but increasing the strength may not overcome resistance. Some even want to try the ORAL drug ivermectin (Stromectol®). This new drug is approved for certain parasitic infections … it isn’t approved for head lice.
One reason physicians are using these longer and stronger treatments is the recent coverage in The Medical Letter (a newsletter to physicians).
But many experts OPPOSE these treatments. Academic dermatologists and the National Pediculosis Association, Inc. say there’s not enough support in the literature for these high-powered treatments. And there are too many unanswered questions.
Stick with the TRADITIONAL approach. Make sure patients know how to apply lice products correctly. Advise them NOT to use a shampoo with conditioners BEFORE using Nix®. The conditioner coats the hair and may protect the nits.
Tell people to DILIGENTLY remove nits … wash clothing … vacuum carpets and furniture, etc.
There’s also controversy over new recommendations about using Nix® to PREVENT lice. The FDA says it’s okay … when over 20% of the people at an institution are infested … or for immediate household members. This is only in the professional labeling. The manufacturer can’t put this on the package for consumers. Try to limit treatment only to people who are infested.