A Pharmacist's Guide to OTC Therapy: Head Lice Products

Yvette C. Terrie, BSPharm, RPh
Published Online: Friday, September 1, 2006

Head lice is the most prevalent form of lice infestation in the United States, affecting approximately 10 million to 12 million individuals. This type of infestation occurs mostly in children aged 3 to 12 years. The peak times for outbreaks of head lice are usually after the opening of the school year between August and November.1

Treatment of Head Lice with OTC Pediculicides

OTC pediculicides contain permethrins and synergized pyrethrins. Both classes of agents are considered to be effective in the treatment of head lice. OTC products for treating head lice are available in a wide variety of forms including shampoos, lotions, rinses, and mousses. In addition, these products typically contain a nit removal comb (Table 1).

The Role of the Pharmacist

Pharmacists can be instrumental in ensuring that these products are used correctly by making certain that patients receive adequate counseling and have a thorough understanding of the proper use of these products. Pharmacists should also remind patients that an effective head lice treatment plan should include the use of one of the various OTC pediculicide products and nonpharmacologic measures in order to prevent the spread of head lice to another individual as well as to prevent possible reinfestation (Table 2).

When used as directed, OTC products can be very effective in treating head lice. If all nits are not gone after the first treatment, a second application should be made. The scalp and hair should be thoroughly examined for at least 7 to 10 days. If head lice infestation persists after a second application, individuals should consult their health care provider immediately for other treatment options. Because there is concern about an increase in lice resistance to pediculicides, it is imperative that pharmacists always remind patients about the overuse of these products, since resistance may be caused by improper use, excess use, or insufficient contact time for these products.1 For more information on head lice, visit the National Pediculosis Association at www.headlice.org.

Ms. Terrie is a clinical pharmacy writer based in Haymarket, Va.

For a list of references, send a stamped, self-addressed envelope to: References Department, Attn. A. Rybovic, Pharmacy Times, Ascend Media Healthcare, 103 College Road East, Princeton, NJ 08540; or send an e-mail request to: arybovic@ascendmedia.com

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