Treatments for Head Lice in Children Don't Always Work
The most commonly used prescribed medication for these problems is lindane (Kwell). Doctors apparently have not figured out yet that it doesn't work and has been associated with some potential safety concerns. Efficacy of lindane has been decreasing over the past few decades to lindane due to the emergence of treatment resistant lice. Lindane has limited efficacy, killing only 17% of lice after a 3 hour period, and none after 10 minutes, the recommended time of exposure. Lindane was less effective than prescription malathion, and over the counter pyrethrin and permethrin. Lindane acts on lice by stimulating their central nervous system similar to DDT. Those with lesions on their head can develop central nervous system toxicity if they apply the lotion on the head. This is an obvious concern for the many little children who are applying this lotion on top of their head for the elimination of head lice, which they may have to do twice. Side effects include dizziness, headache, tingling, and seizures. There have been three confirmed Lindane related deaths. Lindane is contraindicated in children, uncontrolled seizure disorders, and alcoholics. Only one application is recommended.
Malathion (Ovide) is an organophosphate that kills lice by inhibiting the cholinesterase enzyme. Malathion is the most highly effective pediculicide, killing 88% of lice in 10 minutes and 100% in 20 minutes. Malathion also binds to sulfur in the hair shaft and kills eggs. Malathion is highly flammable, so little children treated for lice should stay away from fires, to keep their heads from catching on fire. Side effects are rare and include scalp irritation and eye inflammation (conjunctivitis). Malathion is not absorbed into the body in significant quantities. The product label says to leave on for 8 hours, although this is overkill and may lead to lice resistance and should not be followed. It should not be used in pregnancy or breast feeding.
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