May 1998
ORLANDO, Fla. - An expert in the problems of resistant head lice found an over-the-counter product that makes "head lice from hell" run for cover.
Terri Meinking, MD, assistant professor of dermatology at the University of Miami, said she used HairClear 1,2,3 (Quantum Inc.) on schoolchildren in Key West during recent tests and "everybody was cured" after two treatments.
She was amazed at the reaction with the first application of the product, recommended to her by a colleague in Israel, where it is widely used. "We did a 15-minute application with the nonaerosol pump spray. The lice were just like running out of the head. It was like clowns coming out of the Volkswagen,'' she said at the annual meeting of the American Academy of Dermatology.
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The increasingly resistant head lice are causing problems worldwide and in many places in the United States, according to Meinking, but the Florida Keys are having an especially difficult time. Some children have been out of school 45 to 60 days because of head lice.
"The resistant lice no longer respond to standard treatments," said Lawrence Schachner, MD, professor of pediatrics and dermatology at the University of Miami. More than 100,000 cases of resistant head lice have occurred in the United States in the last few years.
"These head lice are the same one's that have been around for years, but they seem to be unresponsive to standard treatment," said Schachner.
Most of the cases Schachner's handled were in people returning from the Middle East, or were found in people who had been in contact with someone who visited or resides in the Middle East.
Meinking said the Monroe County Health Department in Key West called her when, out of frustration, school nurses began using margarine to try to smother the lice.
"The products that are out there are not working as well as they used to, or not at all," said Meinking.
Meinking, who will be meeting with the Food and Drug Administration regarding clinical trials for HairClear, isn't sure why this medication is working where others are failing. But, the combination of the ingredients - including Ylang Ylang, anise, coconut oil, isopropyl alcohol and rubbing alcohol - is effective. "The direction is certainly to ward a nonpesticide product,'' she said.
The battles with lice have been fought with high technology and low technology. Some doctors are treating resistant head lice with antibacterials, such as trimethoprim-sulfamethoxazole (TMP-SMX). TMP-SMX circulates in the bloodstream and when the lice drink blood from the scalp the antibiotic kills off bacteria in the gut of louse, eventually disrupting the digestive system of the louse and killing it.
"Others simply try higher doses of standard medications, which can be effective but which may also be toxic to the host," said Schachner, who prefers a low-tech approach. "I tell people to take a good glop of petroleum jelly - about 40 g - and cover every speck of hair on the head; every bit of the scalp with the jelly," he explained.
Once the petroleum jelly is covering the head, he then covers the scalp with a shower cap and leaves that in place over night. The petroleum jelly simply asphyxiates the lice.
"It takes about a week of daily showering to get rid of all the petroleum jelly in the hair," Schachner said. "This is a long enough time so that the nits become covered and can't get any air either."
For more information:
- Meinking T. Resistant head lice: the epidemic of the millennium. Presented at the 56th Annual Meeting of the American Academy of Dermatology. Feb. 27-March 4. Orlando, Fla.
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