For those who still want more information about over-the-counter and prescriptions medications

Over-the-counter Medications

Many head lice medications are available "over-the-counter" without a prescription at a local drugstore or pharmacy. Each over-the-counter product approved for the treatment of head lice contains one of the following active ingredients:

PYRETHRINS (PIE-WREATH-RINS) COMBINED WITH PIPERONYL BUTOXIDE (PIE-PER-A-NIL BEU-TOX-SIDE);

Brand-name products:

A-200, Pronto, R&C, Rid, Triple X

Pyrethrins are naturally occurring pyrethroid extracts from the chrysanthemum flower. Treatment failures can be common depending on whether lice are resistant to pyrethrins in the patient's geographic location. Pyrethrins generally should not be used by persons who are allergic to chrysanthemums or ragweed. Twenty to 80 percent of treated nits survive, necessitating a second treatment seven to ten days after the first application.

PERMETHRIN LOTION 1% (PER-METH-RIN);

Brand-name product:

Nix

Permethrin is a synthetic pyrethroid similar to naturally occurring pyrethrins. Permethrin lotion 1% is approved by the FDA for the treatment of head lice. Treatment failures can be common depending whether lice are resistant to permethrin in the patient's geographic location. Studies suggest that lice have developed resistance to this drug. Permethrin is not approved for use in children less than 2 years old.



Prescription Medications

The following medications approved by the U.S. Food and Drug Administration (FDA) for the treatment of head lice are available only by prescription:

MALATHION LOTION 0.5%;

Brand-name product:

Ovide

Malathion is an organophosphate. Malathion lotion 0.5% is approved by the FDA for the treatment of head lice. Malathion is intended for use on persons 6 years of age and older. Malathion can be irritating to the skin and scalp; contact with the eyes should be avoided. Malathion lotion is flammable; do not smoke or use electrical heat sources, including hair dryers, curlers, and curling or flat irons, when applying malathion lotion and while the hair is wet.

LINDANE SHAMPOO 1%;

Brand-name products:

None available

Lindane is an organochloride. Although lindane shampoo 1% is approved by the FDA for the treatment of head lice, it is not recommended as a first-line therapy. Overuse, misuse, or accidentally swallowing lindane can be toxic to the brain and other parts of the nervous system; its use should be restricted to patients who have failed treatment with or cannot tolerate other medications that pose less risk. Lindane should not be used to treat persons with a seizure disorder, women who are pregnant or breast-feeding, persons who have very irritated skin or sores where the lindane will be applied, infants, children, the elderly, and persons who weigh less than 110 pounds.