In recent weeks there has been the release of a new product that suffocates head lice and a study by French and British researchers that show the effectiveness of an oral medication to treat head lice traditionally used for treating certain roundworm infections.

Millions of schoolchildren bring home head lice annually with the normal treatment being diluted forms of the insecticides, permethrin and malathion. However, like bacteria get with antibiotics, the head lice have been showing increased resistance to these treatments, leaving parents picking the lice and nits out of the hair with a comb.

The first product is Ulesfia lotion. This 5% benzyl alcohol lotion works by suffocating the lice. It is not a poison like those mentioned above; instead it kills the louse using physical means.

The adult head louse has breathing apparatus’ on its thorax called spiracles. The Ulesfia lotion fills the spiracles and doesn’t allow the spiracles to close causing suffocation.

The treatment is done at day 1 to kill adults and at 7 days to kill new hatchlings before they can reproduce.

Because it kills based on physical means unlike permethrin or malathion, future resistance is unlikely. This treatment can be used on children as young as 6 months old.

The second treatment option comes from a study in the New England Journal of Medicine. Researchers tested over 800 patients and randomly treated with topical malathion and the oral pill, ivermectin.

Ivermectin is a anti-parasitic drug used to treat onchocerciasis and strongyloidiasis.

The study showed that at 15 days the 95 percent of ivermectin treated patients were lice free while only 85 percent of the malathion treated patients had the same outcome.

Not only has permethrin and malathion lotions shown increased resistance in recent years, but there has always been the issue of compliance. With treatments like these, keeping the lotion in the hair for up to 12 hours is required prior to washing it out, and we know that doesn’t always happen.

Because ivermectin could also show resistance at some point, it is only recommended for the most difficult cases.

Pediculus humanus capitis, or the head louse is a ectoparasite is found on the scalp and facial hairs of infested individuals. They do take blood meals but are not known for transmitting infectious diseases.

Because the head lice cannot jump or fly, direct contact with an infested person is required to get it. Contact with infested personal items and clothing is also a vehicle for transmission. A lack of personal hygiene has nothing to do with getting head lice.