Ask Your Pharmacist

August 08, 2022

Q:

My grandson came home from day camp with a note that there is an outbreak of head lice.  What recommendations can you make?

A:

Your grandson is not alone!  It has been difficult to keep treatment for head lice on the shelf over the last few weeks.  Head lice is a common nuisance and inconvenience during our New Brunswick summer and fall season.  In the past, it was a common misconception that having head lice was related to cleanliness and personal hygiene.  Today, we know that catching lice is not related to household conditions and personal hygiene in the majority of situations  so don’t take it personally if your child catches lice. Instead, talk to your pharmacist to find the best treatment for your little one so they can get on with enjoying summer.  

Head lice (Pediculus Capitis) are wingless insects that attach to the roots of hair on your head where they lay eggs (nits) and feed on the scalp, causing itch and irritation. Lice are spread by direct contact between the hair of children and adults or by sharing things that have touched an infected head like hats, combs, headphones, helmets, pillows or bedding. Contrary to popular belief, lice can’t jump. They can survive only two or three days if they aren’t on a human head. They cannot survive in carpets or on pets. Back-to-school provides an opportunity for kids to share hats or be in close contact with other heads. That’s likely why children ages five to 12 years old commonly catch lice.  
When checking your child’s hair, if you do see any live lice, then you will want to see your pharmacist to discuss treatment options. 

The most commonly used option is Permethrin 1% (NIX and Kwellada-P) because it is extremely effective and cost-effective. Resistance to Permethrin is becoming more widespread.  If you have recently used Permethrin to treat an infection of head lice on your child, choosing a different agent makes good sense in case the lice have developed resistance.  If your child has a ragweed allergy, stay away from Permethrin. Resultz (a rinse) and Nyda (a spray) are also available, proven and effective options. Neither has the risk of resistance as the reason for treatment failure, but both are more expensive. Whichever treatment you use, be sure to use a fine-tooth comb to remove all lice and eggs.  It is now recommended to repeat the treatment in one week just in case any eggs hatch. Any clothing, bedding and hats that have been worn in the last week should be washed in hot water or placed in a bag for two weeks. Also, check all family members and treat only those who have lice present.

Head lice is probably more common then you think, and as our population continues to grow, it’s unlikely that will change. If you have children aged five-12 years of age and you see them scratching their scalp, check for lice. Regular checks are not a bad idea during back to school season especially. Not repeating treatment is the most common reason that lice come back and this may lead to further resistance, so I highly suggest not skipping this step, even if you can’t see any lice or nits. If you have any further questions, speak to your pharmacist.
You can also discuss with your pharmacist options to prevent head lice including tea tree oil, and tea tree shampoo.
Dr Kevin Duplisea (PharmD BSc. Pharm, BSc. ACPR) is a pharmacist at Shoppers Drug Mart in Quispamsis, New Brunswick. His opinions expressed in this newspaper are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. Send your questions to AskYourNBPharmacist@gmail.com.