While there are a variety of natural head lice treatments that parents can try, a moderate to severe lice infestation may require a medicated head lice shampoo. Over-the-counter treatments which can be purchased at a drugstore may contain one of three active ingredients. Doctors can prescribe stronger medications, but these are significantly more toxic than their non-prescription counterparts.
Over-the-Counter Head Lice Shampoos
Head lice shampoos are basically pesticides, so the thought of spreading one all over a child’s head, especially an infant's or toddler's, is not appealing. However, effective elimination of a lice infestation may require their use, and doctors consider them safe for children. They are certainly safer than prescription medications for head lice, so it’s best to use them according to their labels and knock out the problem on the first attack.
Pyrethrum and Pyrethrin for Head Lice
These extracts of the chrysanthemum plant may be combined with piperonyl butoxide in order to increase their potency. They are effective at killing lice, but not their eggs (nits). They are usually less expensive than permethrin treatments, but parents must be extremely vigilant in removing all of the nits or the infestation will recur.
It is recommended to do a second shampooing 7 to 10 days after the initial treatment in order to catch any newly-hatched lice. Pyrethrum and pyrethrin are safe for children 2 years of age and up. For younger children, consult a physician.
Side effects of pyrethrum and pyrethrin include difficulty breathing and/or asthma attacks in those allergic to ragweed. Minor itching or irritation of the scalp is common.
Permethrin Shampoo for Head Lice
Permethrin is a synthetic pesticide that is the safest of all medicated treatments. It is safe for babies as young as two months of age. Permethrin is an excellent choice also because it is effective in killing the nits as well as the live lice. Permethrin also tends to remain in the hair, preventing re-infestation for up to 14 days.
While it is still prudent to remove as many nits as possible, the fact that permethrin kills unhatched lice puts it ahead of other over-the-counter treatments since removing every single nit in a head of hair is the most difficult and daunting part of treating head lice. Killing the nits also means that only one shampooing is generally needed to end the infestation.
Permethrin carries similar potential side effects to pyrethrum and pyrethrin.
Prescription Head Lice Shampoos
Prescription head lice shampoos are very toxic and should be avoided if at all possible. In fact, parents should only consider using prescription shampoos such and Lindane or Malathion if all other measures have failed twice.
- Lindane. The U.S. Food and Drug Administration (FDA) has issued a warning that Lindane shampoo for head lice and Lindane lotion for scabies can cause serious side effects including seizures and death. These side effects are more common in babies and children, the elderly, and those weighing less than 110 pounds. Side effects are also more common when a second treatment of Lindane is given, although side effects can occur even when Lindane is used as directed.
- Malathion. Also sold as Ovide, this prescription pesticide is only recommended for children ages six and older. Ovide is extremely flammable, so children should not be allowed near flames, cigarettes, electric hair dryers or curling irons while the shampoo is applied. While not as toxic as Lindane, malathion should only be considered after all non-prescription attempts to remove lice have failed, says renowned pediatrician Dr. Wiliam Sears in his article "Head Lice" published on AskDrSears.com in 2006.
Failure to follow the instructions can result in an ineffective application of the medication, which can leave some lice alive to carry on the problem, or, worse yet, can cause the lice to become resistant to that particular chemical, making them that much harder to kill.
While there are a variety of non-medicated lice treatments available, the truth is that the use of an over-the-counter medicated shampoo is probably the best first line of defense in the case of a moderate to severe head lice infestation. Understanding how these products work, their level of toxicity, and how to safely use them gives parents and caregivers the power to choose the best option for their family.
Understanding the life cycle of the louse and how to clean the house during and after a lice infestation can also help prevent re-infestation in school aged children, adults and babies or toddlers.
Christy Swift - Christy Swift is a stay-at-home mom of two girls and a freelance writer. She has volunteered as a doula for young and underprivileged ...
