When teachers open their classrooms to students this fall, they’re also inviting an unwanted guest: head lice. Any parent who’s gone several rounds with a nit comb and a squirming child knows how maddening it can be to fight the tiny, persistent parasites.
Now, there’s a new prescription treatment in the battle against lice, recently approved by the FDA.
“We took families that had heavy infestations of head lice and we were clearing these kids, and some adults, with one treatment,” says dermatologist Dow Stough, who has a private practice in Hot Springs, Ark., and who performed clinical trials of the new product. “I was like, wow, they really have something.”
The new prescription hair rinse, Natroba Topical Suspension, was approved by the FDA in January and went on sale in August. Clinical studies showed it could rid a patient of lice after just one treatment, and without the hassle of combing out lice eggs.
Lice ingest Natroba’s main insecticide, spinosad, and begin to shake, until they exhaust themselves — to death.
In clinical trials, 84 percent of participants were lice-free after 14 days. That’s compared with 44 percent of people in the study treated with Nix, today’s most commonly prescribed head lice product.
Still, over-the-counter products with the ingredient permethrin, such as Nix, should remain your first line of defense, according to Barbara Frankowski, pediatrician and author of the American Academy of Pediatrics policy statement on lice. These options have a proven safety record, she says. “If it works, why drive up the cost of medical care by using something way more expensive?” For families who prefer not to use pesticides, applying petroleum jelly or Cetaphil weekly for three weeks with careful combing works. “Tedious and time consuming, but doable,” she says.
If non-prescription techniques do fail, then Frankowski says a pediatrician can prescribe a product such as Ulesfia, Ovide, or Natroba. But that could cost you.
Natroba costs the average family about $36 when covered by insurance, or $219 without coverage. Meanwhile, a family pack of Nix lice treatment sells for about $15.
The problem with existing treatments is that their frequent use has built a population of permethrin-resistant lice. Yes, it’s not your imagination — they’re getting harder to kill. But the insects have yet to develop resistance to new treatments like Natroba.
“I expect it will be more effective than products in which geographic resistance patterns have been well established in the U.S.,” says Shirley Gordon, director of the Head Lice Treatment and Prevention Project at Florida Atlantic University.
Count Laura Mitchell, Phoenix mom of three, among the panicked parents who lost the lice battle with an over-the-counter solution. She received the dreaded call from the school nurse days before her extended family was due to arrive for the holidays. She treated her 6-year-old daughter with the pesticide suggested by the nurse. Then she took a look at her daughter’s scalp under a bright light.
“At first, I thought it wasn’t so bad, there weren’t that many nits,” she says of the eggs that stick to hair like glue. “Then my eyes adjusted and I saw that there were literally thousands, each little nit attached close to the scalp on each little hair strand. It was overwhelming.”
She booked an appointment with the region’s “Lice Lady,” Michele Earl, who gave the Mitchells comb-outs and a natural shampoo. Laura bagged every pillow in her house, boiled all the brushes, washed and dried all their sheets and clothes on high heat, and vacuumed like crazy until the lice were no longer.
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Bill Culpepper III, the president of the pharmaceutical company that makes Natroba, ParaPRO, has personal experience with the insidiousness of lice: Before the FDA approved Natroba, his family was hit with an infestation. He and his wife treated their 7-year-old son and 10- and 12-year-old daughters with over-the-counter solutions several times and spent weeks attacking their daughters’ long hair with a nit comb. “It’s not a bonding experience, let me tell you,” he says.
The good news, from his perspective, is that the new treatment promises to get rid of lice without tedious nit-combing. The nits left in the hair after a regimen of Natroba don’t appear to hatch.
But who wants to walk around with nits in their hair, dead or alive?
“If a parent wants to nit comb for aesthetic purposes, that’s up to them,” says Culpepper. “But it’s nice to know you don’t have to comb for hours and hours every night.”