Why Head Lice Products Don’t Work

When a child has head lice, most parents go into emergency mode. Due to a potent combination of fear and embarrassment, parents want to get rid of the lice as quickly as possible. So they race to the drug store and grab an over-the-counter (OTC) lice-removal product and rush home to use it.

There are three problems with this approach.

First, a majority of OTC products don’t work any more, at least not in the United States. “Virtually all lice in the U.S. have developed resistance to over-the-counter and prescription shampoos containing the toxic chemical Permethrin,” says the website Beyond Pesticides about the active ingredient in lice-removal products. Several recent studies have confirmed the widespread resistance of head lice to retail products.

“This isn’t really controversial,” said John Clark, a professor of environmental toxicology and chemistry at the University of Massachusetts, Amherst and co-author of one of the studies of resistant head lice. “This is a problem we’ve been showing in development over a period of about 20 years. But our new work now shows that head lice are now almost 100 percent [resistant]. That means there’s an awful lot of resistant insects out there in the U.S. and elsewhere.”

Reason #2 not to use commercial lice-removal products: They may not be safe. Permethrin is a neurotoxin that kills lice by shutting down the insect’s central nervous system. Lice-removal products have been deemed safe when used as directed, but overuse is common—panicked parents often over apply the product—and it may cause serious health problems. Richard Clapp, an environmental health expert and professor emeritus at Boston University, has said that Permethrin, especially when combined with other problematic chemicals, can cause seizures and, down the road, behavioral problems. In a 2009 memo, the EPA classified Permethrin as “likely to be carcinogenic to humans” in some conditions.

Another concern is that “environmentally relevant levels of Pyrethroids”—the class of pesticide that includes Permethrin—are also common in many homes, where they are used in some household insecticide products.  This means that adding lice shampoo, even the amount directed, to the level of Pyrethroids already in a home can over expose children to the pesticide.

The third reason for thinking twice before using OTC lice-removal products is that they don’t kill lice eggs, or nits, which are the real problem in the battle against head lice. “Pyrethrins (another type Pyrethroids) can only kill live lice, not unhatched eggs (nits),” according to the Centers for Disease Control and Prevention. Nits are affixed to hair follicles with a very strong glue-like substance and must be manually removed, one-by-one. If every nit is not removed, you’ll simple get a new case of head lice a week or so after the treatment is applied. Many experts recommend manual removal as the only really reliable way to remove lice at all. If you’re going to comb through a child’s hair strand-by-strand anyway, they reason, why risk the exposure to pesticides?

So, here’s a recap of the three reasons to pause before running to the drug store to buy a pesticide-based lice-removal product: They don’t work; they may not be safe; and they don’t kill the lice eggs.

Fortunately there is now a pesticide-free alternative to lice-removal medications. It’s a medical device (rather than a shampoo) that uses heated air to dehydrate and kill head lice and 99.2 percent of lice eggs. It has been clinically proven to be safe and effective and has been cleared for use by the FDA. It is called AirAllé, and treatment using this device is available exclusively at Lice Clinics of America treatment centers throughout the United States and around the world. In most cases the head lice are removed in a single 60-90 minute treatment, and the treatment is guaranteed to be effective by the clinic.

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