The use of insecticide-containing shampoos to treat head lice is considered quite safe as long as the directions are followed. The safety of sprays intended for use on furniture and bedding that contain similar ingredients, however, is a subject of some debate.
"Our organization is vehemently -- and I can't use that word strongly enough -- vehemently opposed to sprays," says Deborah Altschuler, president of the National Pediculosis Association, Newton, Mass. The insecticide ingredients in lice sprays are toxic and can cause complications ranging from irritation to death for patients, says Altschuler. "There is no scientific basis to use lice sprays. They are unnecessary because lice are human parasites."
As parasites, lice cannot live for an extended period unless they are on the human body.
"The simple alternative is to vacuum furniture and wash bedding," Altschuler suggests.
Pharmacists who spoke with Supermarket Pharmacy were split as to whether or not to recommend such products to patients. All agree, however, that there is a need for caution regarding the sprays. Active ingredients used in some sprays include resmethrin 0.5%, pyrethrins 0.3%, and piperonyl butoxide technical 1%. The last two ingredients are commonly found in shampoos used to treat head lice.
Of the pharmacists who say they would not recommend sprays, most explain there are better and safer alternatives to eliminating lice from bedding, furniture and carpets than using a spray.
"I never recommend the sprays," says Allen Miller, pharmacy manager of Boyles Pharmacy inside Broulims Supermarket in Rexburg, Idaho. He recommends bleach and hot water to kill them on bedding, clothes and furniture, or sealing infested textiles in a plastic bag for at least 10 days because the lice need a human host to survive. Butch Henderson, pharmacy director of Klein's Pharmacies, inside Klein's Super Thrift Markets in Forest Hill, Md., agrees.
"Sprays may not be totally safe," he explains. "Generally we tell patients to clean clothes or bedding very well." Other pharmacists will recommend sprays, but emphasize they are to be used with caution and only under certain circumstances.
"We generally only recommend sprays for permanent furniture like a chair or something that can't be washed," says Walter Drach, pharmacy manager at Countryside Drug Co. II, located inside Leppink's Food Center in Lakeview, Mich. "The sprays should especially not be used on animals. I don't feel it's necessary to spray on the bedding, because that's a place your face will be in contact with for a long period of time and that type of medication you have to be careful with because it can cause some nerve damage."
Frank Chibaro, supervising pharmacist at Pharmacy of Columbia Park inside Singer ShopRite in North Bergen, N.J., says he does recommend lice sprays.
"I tell patients they should try and hit the main areas, the places where the child is most likely to be around," Chibaro says. "The sprays are still on the market, so I don't have a problem with them."
NPA's Altschuler counters that exposing children to pesticides in shampoo is "insulting enough. It is yet another major insult to the child's personal environment to spray the place where they sleep. Altschuler explains that NPA's new national reporting registry, which began this year, has helped the organization gather information about lice sprays. The 24-hour hot line records the public's reports of lice outbreaks, as well as "lice treatment failure and adverse reaction to treatments," Altschuler says.
"The symptoms we have heard are as acute as difficulty in breathing and as extreme as death," she says.
One manufacturer, though, says he would like to see actual results of studies to support Altschuler's claims.
Says Michael Schiffmiller, senior product manager for Pronto, made by Del Laboratories, Farmingdale, N.Y.: "All the major brands have spray products. I've heard anecdotes, but have seen no real data yet."