Nit combing can be a tiresome and not always effective process, as nits are extremely small and appear like dandruff. Further, the process of treatments and combing may have to be repeated again and again, and head lice can often develop a resistance to traditional medications. This is why these new trial results are so important for the mental wellbeing of parents and school officials, as they showed that a drug called ivermectin (Sklice) eliminated lice after just one application without the need for nit combing.
Ivermectin lotion cleared 94.9% of patients of lice one day after treatment, compared to 31.3% of the controls. One week after treatment this was 85.2% vs. 20.8%, and two weeks after treatment, 73.8% vs. 17.6%. Ryan Mitchell Associates sponsored the trials, and the company’s William Ryan, BVSc and his colleagues, said their results ‘indicate that ivermectin is a treatment option when permethrin or pyrethrins have failed or when there is a desire to reduce the need for nit combing and increase the probability of success with a single application.’
Sklice was approved by the FDA in February 2012 for treatment of head lice in anyone ages 6 months and older. The ivermectin in the lotion works by attaching to the nerve and muscle cells of lice, which paralyses and kills them. Olivier Chosidow, MD, PhD, of the French National Institute of Health and Medical Research (INSERM), and Bruno Giraudeau, PhD, of INSERM, noted in an accompanying editorial that the lotion is ‘indeed welcome and is expected to have less risk of systemic adverse events’.
However, the INSERM experts also warned that ivermection should not be the first treatment parents or physicians reach for when treating head lice: ‘With good comparative-effectiveness research still lacking, indirect comparisons…support the 2010 American Academy of Paediatrics recommendations to use 1% permethrin or pyrethrin insecticide as first-line therapy’. Yet, as there is a growing resistance to these first-line treatments, ivermectin could prove to be an effective alternative.