Getting the bugs out
Now that school is back in session, it’s only a matter of time before children start coming down with the most common of pediatric health problems: head colds and head lice.
There’s no cure for the common cold, and the treatments for head lice can be ineffective and difficult to use. Although the first problem is unlikely to change anytime soon, a Menlo Park, Calif., dermatologist may have found a fix for lice problems.
Reporting last month in the journal Pediatrics, Dr. Dale Pearlman said he had come up with a way to kill head lice by smothering them with a dried-on lotion. If proven effective, the solution would be a blessing for millions of children and their parents.
“There really is a need to find the next remedy for head lice,” said Pearlman. “Parents are more upset and frustrated by head lice than any other medical problem I see.”
Lice attach to the hair and scalp of humans, feeding on their victims’ blood and laying eggs, called nits, in their hair. Outbreaks are most common among school-age children; about 6 million to 12 million U.S. children are affected each year. The standard treatment is to remove the nits with a special comb and apply a lice-killing pediculicide -- a shampoo or lotion with chemicals.
The treatments are quite painstaking, and they don’t work very well because lice have become resistant to many of the chemicals in over-the-counter remedies, said Pearlman. Prescription remedies containing stronger chemicals may be more successful, but some parents and doctors worry about applying potentially toxic insecticides to a child’s skin. Last year, the Food and Drug Administration issued a warning about one such substance, lindane, stating that the lotion should be used with care and only if other treatments had failed.
Pearlman began working on a remedy about eight years ago when he noticed that current treatments were becoming less effective. To avoid the problem of drug resistance, he focused on killing the lice by smothering them. Folk remedies, he knew, took a similar approach, using a layer of mayonnaise, peanut butter or petroleum jelly, for instance.
“Smothering is believed to work by cutting off the bugs’ air supply,” he said. “But there were no well-controlled studies showing that any of these remedies worked.”
Many of the substances used to smother the bugs rubbed off too easily, Pearlman concluded; his lab research showed that the bugs’ air supply had to be cut off for at least eight hours.
Using a mixture of nontoxic chemicals, Pearlman created a lotion that is applied to the head and blow-dried so it won’t rub off. The lotion, which he calls Nuvo, is invisible and odorless once the hair is dry; it is left on for at least eight hours. The treatment is repeated once a week for two weeks. Lice that hatch after the first treatment are killed in the subsequent treatment. Because lice eggs must hatch within 10 days, the life cycle is disrupted by the treatment, Pearlman said.
Pearlman tested his product on 133 patients in two studies. In the first study, 93 children used the lotion, plus had nits removed by combing. In the second study -- of 40 children -- only the lotion was used. The cure rate was 97% in the first group and 95% in the second. After six months, about 94% of both groups remained lice-free.
Dr. Susan S. Aronson, a pediatrician at the University of Pennsylvania, says additional studies are needed to prove the remedy’s effectiveness. Other suffocation remedies that showed early promise were later proved to be ineffective, she said. “He does not have the double-blind, placebo-controlled study that would have demonstrated whether his product was responsible for the cure,” she said.
Another flaw, Aronson said, was the use of combs to remove excess lotion from the children’s hair, which may have removed the nits. In the first study, parents were instructed to use a special comb to remove nits. In the second study, parents just used a pocket comb to remove the excess lotion. The combing step may have skewed the findings, she said, and raises doubts about the validity of the treatment.
Pearlman agrees that additional studies are needed, and said he hoped to team with a drug company to conduct the tests and bring Nuvo to market as an over-the-counter product. For now, the treatment is only available in his office.
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About head lice
People do not get head lice because of poor hygiene. Anyone can get lice.
Frequent head scratching is often the first sign of head lice.
Lice can move fast and may be difficult to see. Nits are tiny and oval shaped and become attached to the hair shaft at an angle. Nits can be found anywhere in the hair but are usually near the scalp.
If someone in the family has head lice, everyone in the family should be checked.
When using treatments to remove head lice, follow directions carefully.
Lice do not infest the home, but washing bedding, towels and clothing in hot water is important to kill lice that might be easily transferred to a human head. Lice don’t survive very long, however, if they are not on a human head.
No treatment is considered 100% effective.
Source: American Academy of Family Physicians
