LICE
Treatment:
Permethrin
- Remains active for >2wks, poorly absorbed from
skin; rapidly metabolized and excreted in urine
- 1% form (Nix) is available OTC; some resistance
has been reported
- 5% form (Elimitie) requires prescription;
approved only for tx of scabies; can use it
applied to clean, dry hair and left on 8-12h
under a shower cap
Pyrethrins
- Natural chrysanthemum extract, us. combined with
piperonyl butoxide
- Safe, fairly effective (but not as much as
permethrin) but with frequent tx failures
- Need 2nd tx 5-7d after first b/c don't kill all
unhatched eggs
Malathion-no longer available in U.S.
Lindane
- Slow-killing pesticide
- 1% shampoo, apply x 4minutes then repeat 1wk
later
- Probably safe but can have CNS toxicity if
overused or ingested; resistance is common with
repeated tx
Ivermectin
- Single PO dose 200ug/kg highly effective for
scabies and head lice with "virtually no
adverse effects" (Med Letter 1/17/97)