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Medications for Head Lice

Prescription Medications for Head Lice

Several types of prescription medicines for head lice are also available. These include:
  • Malathion (Ovide®)
  • Lindane (Kwell®)
When used as directed, malathion is effective in treating lice. Some medication remains on the hair and can kill newly hatched lice for seven days after treatment. The medication is intended for use on people six years of age and older, and few side effects have been reported.
Some precautions with malathion to be aware of include the following:
  • Malathion may cause stinging, especially if the scalp has open sores from scratching.
  • Malathion is flammable. Keep it out of the eyes and away from heat sources, such as hair dryers, electric curlers, cigarettes, or open flames.
  • Pregnant and nursing mothers should use malathion only after consulting their physician.
Suggestions for applying malathion include the following:
  • Before applying malathion, remove all clothing from the waist up.
  • Apply the product according to label directions to hair that is dry until the scalp and hair are wet and thoroughly coated. Leave the medication on the hair for 8 to 12 hours; then allow the hair to dry naturally. Have the person put on clean clothing once medication has been applied. (Consider treating just before bedtime. Once malathion has been applied to the hair and scalp, cover any pillows with a towel to keep the medication from staining the pillow.)
  • After 8 to 12 hours, thoroughly wash hair.
  • A nit comb should be used to remove lice and nits from the hair. Many flea combs made for cats and dogs are also effective for this purpose.
  • After treatment, check hair for lice, and comb hair with a nit comb to remove nits and lice every two to three days. Continue checking for two to three weeks until you are sure all lice and nits are gone.
  • If adult lice are found 7 to 10 days after treatment, retreat with either the same or a different medication.
When used as directed, lindane is generally safe. Overuse, misuse, or accidentally swallowing it, however, can be toxic to the brain and other parts of the nervous system. For those reasons, lindane is generally used only if other medications have failed.
It should not be used if excessive scratching has caused open sores on the head. In addition, it should be used with caution in persons who weigh less than 110 pounds.
Benzyl Alcohol Lotion
Benzyl alcohol lotion is a relatively new prescription medication, approved in 2009. It is approved for treating head lice in individuals as young as six months of age. The lotion works by temporarily paralyzing the breathing holes of the lice, allowing the inactive ingredients in the lotion to suffocate them.
It is applied to the hair for 10 minutes and then rinsed off. The treatment is repeated after seven days, since the drug does not kill the eggs. You may shampoo the hair immediately after the product is washed off.
Because benzyl alcohol can cause a dangerous group of side effects (known as "gasping syndrome") in newborns, this product should never be used by newborns, especially those who are premature.
Side effects of benzyl alcohol lotion are uncommon and are generally mild. Such reactions may include temporary numbness or skin irritation at the application site.
Spinosad was approved in 2011. It causes lice to become hyperactive, after which they become paralyzed and die. Spinosad is derived from the fermentation of a certain type of soil bacteria. It is also used as an insecticide in lawn and garden products.
Spinosad is applied to the hair for 10 minutes and then rinsed off. A second treatment may sometimes be necessary one week later. It is approved for use in individuals age four years and up.
Side effects of spinosad are generally minor. Common reactions include redness or irritation of the application site and redness of the eyes. Studies have shown that spinosad is quite a bit more effective than permethrin cream.
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About Head Lice

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