SNOWBIRD, UTAH -- Maybe those "superlice" aren't so super after all.
According to one pediatric dermatologist, recent reports of treatment-resistant lice may reflect failure to prevent reinfestation.
"Parents have to be really fastidious about environmental control and nit picking," Dr. Sheryll L. Vanderhooft noted at a seminar on clinical dermatology sponsored by Westwood-Squibb.
Unfortunately, many probably are not, largely because they dislike combing through their children's hair to look for nits.
Environmental measures to eradicate lice, including washing clothing and linens and vacuuming floors and furniture, may also nor be undertaken fully enough to do the job, she said.
It can be difficult for physicians to emphasize the need for these measures without fostering parasitophobia, or "lice hysteria," said Dr. Vanderhooft, director of the pediatric dermatology clinic at the Primary Children's Medical Center in Salt Lake City.
If standard treatment measures fail despite good follow-up care, Dr. Vanderhooft advised trying 5% permethrin cream (Elimite) applied to dry hair overnight, using a shower cap to provide occlusion. The treatment can be repeated in a week if necessary.
The newest treatment for head lice is malathion 0.5% lotion (Ovide), which was recently approved by the Food and Drug Administration for this application. "I haven't had any experience with it yet," Dr. Vanderhooft commented at the seminar.
Other treatments include ivermectin, which is not recommended for babies weighing less than 15 kg, and trimethoprim-sulfamethoxazole, which should be limited to patients with secondary bacterial infections of the scalp because of the potential for drug interactions.
Home remedies, such as petrolatum, mineral oil, or mayonnaise, also can be tried. Avoid using nonfat mayo because it is less effective, said Dr. Vanderhooft, who also is with the department of dermatology at the University of Utah in Salt Lake City.
COPYRIGHT 2000 International Medical News Group
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