Although lice-treatment products are usually available in the first-aid aisles of most supermarkets, many shoppers turn to the supermarkets' pharmacies for advice and counseling.
ts for home care. The literature is usually provided by pharmaceutical companies such as Wellcome and Pfizer.
"I try to determine how many patients are being treated and whether they are doing anything to clean the premises," said Diana Ross, a pharmacist at Albertson's in Winter Park, Fla. She usually gives parents a printout. "I tell them all bedding has to be washed thoroughly in hot water," said Howard Silverman, a pharmacist at Winn-Dixie Marketplace in Cape Coral, Fla. "They have to clean the rugs, the child's toys, the bedclothes. There could be a bug harboring in winter clothes."
Kids can get infected more than once if parents don't treat the problem correctly, warned Roger Taylor, a pharmacist at Fry's Food & Drug Stores in Phoenix. "You can treat the child, but if there's lice on the stuffed animal, the bed, the clothes or the furniture, the child can get reinfected," he said.
Adults can get head lice if they share their children's hairbrushes. Pharmacists have also seen cases in homeless people. What products do pharmacists recommend for treatment of head lice?
"I usually recommend the Nix cream rinse," Ross said.
"I personally recommend Nix. I also recommend RID. A200 is an older product," Press said. Only parents who follow the instructions meticulously avoid a second treatment, he noted.
"I recommend Nix over the other ones because they are protected for 14 days," said Susan Ostroski, a pharmacist with Publix Pharmacy in Publix Supermarkets, Tampa, Fla. "Usually you don't need a second treatment. You just apply it the one time and it coats the hair for 14 days even if you wash it. This kind of thing you want to get rid of and not see it again."
"Nix is not cheap, however," Ostroski added; a two-ounce bottle, which comes with a small comb, costs $8.99. RID and A200 are slightly less expensive.
Nix is the leading brand, with 36% of the market share, followed by RID, which has 29% of the market. The prescription-only treatment, Lindane (marketed as "Kwell"), is often sold to customers who are insured for it.
"But, if after 10 or 12 days the nits are not out, they may need a second application of Lindane," Ostroski said. "The eggs tend to hatch in 10 or 12 days."
"I explain to parents that [one application] will generally do it," Silverman said. "The lice are usually killed off with the shampoo. The eggs are the tough things. They have to be taken out with a very fine comb."
"Parents should know you can't treat [the lice problem] every week," warned Silverman. "All the chemicals in the shampoos are harmful if they are used too frequently."
Over-the-counter shampoos may not be effective if the products are not used correctly. Some lice may also resist the chemicals. If this happens, the NPA recommends that product use be discontinued. Manual removal is the suggested alternative.
"We do not recommend the use of Lindane. It is the most toxic chemical," said Linda Menditto, administrative director of the NPA. "It can pose [a danger] to children and adults." The NPA also wants parents to avoid lice sprays. "Vacuuming is a safer and more effective alternative."
Menditto points out that President Clinton recently passed a bill that protects children from pesticides in food. "The FDA, however, approves the use of Lindane for children's scalps and pesticidal sprays for children's beds," Menditto said angrily.
"Lindane is absorbed through the skin and may be toxic," Silverman said. "I haven't seen a prescription for that in three years."
