New Treatment Approved for Head Lice

Nothing makes your head itch like hearing someone has head lice! Immediately, we all cringe and reach up for a quick scratch. Who gets lice? Primarily grade school aged girls (5-11 years old). Girls that age live with their heads tightly paired up with their best friends, sharing hairbrushes, pillows, headbands and hats. Certainly boys get lice, too, and people of all ages are susceptible. In the United States alone, we have between 6-12 million cases per year!

Lice come in two flavors- head lice and pubic lice- and they do not jump from one body part to another. Head lice stick to scalps, and pubic lice attach to the coarse pubic hair, or possibly coarse underarm, mustache, or eyebrow hairs. Lice are obligate parasites, requiring humans for their life cycle. The adults are 1-3mm long (so they are visible to the naked eye.) Most often, lice are recognized by seeing nits, which are the eggs that attach to hair near the base of the shaft. They look like tiny clear or white ovals stuck on the hair, and they will not be easily detached (as opposed to flakes of dandruff, which you can flick off easily.)

Lice can be treated with a couple different over-the-counter products- Rid and Nix. These products kill the adult lice, but not the eggs, so typically treatment is repeated one week after the initial treatment. There are also special combs that help to physically remove the nits from the hair. The FDA has recently approved another lotion called Sklice, with that active ingredient being ivermectin. (You might recognize this medication from your pet, as ivermectin is used to prevent heartworm.) The apparent advantage is that only one ten minute application resolves most lice infestations without the need to remove the nits.


Is Sklice better than the products we already have? Maybe, but we don't have any head-to-head comparison studies yet (pardon the pun.) Certainly, if it reduces or eliminates the need to "nit-pick", this will represent a very significant advantage over our existing treatments.

BOTTOM LINE: If you or your child get head lice, talk to your doctor about the treatment options, including the newly approved Sklice. (Note that Sklice will not be available in pharmacies for another couple of months.)

CDC Now On Board for GARDASIL for BOYS

This week the Advisory Committee on Immunization Practices (ACIP) unanimously voted to recommend that 11-12 year old boys be vaccinated against HPV (the Human Papilloma Virus)- hooray! Girls have NO monopoly on genital warts, which affect over one million Americans each year. They are COMMON. Sadly, in my clinical experience, little harms self-image like a young person developing these genital lesions, especially because we cannot simply cure them and make them go away forever.

Genital warts are transmitted by direct skin-to-skin contact, and though this usually occurs during sex, actual intercourse is certainly not required to pass them on. They are very contagious, with transmission rate of up to 65%. Warts typically recur despite treatment, and frankly, the treatment is unpleasant at best- we burn the warts chemically or with liquid nitrogen. If you've ever had a wart frozen/burned off your knee, you know what that feels like, and the genital area has more nerve endings. Enough said!

The Gardasil vaccine immunizes recipients against the two strains of HPV (6& 11) that cause 90% of genital warts. Additionally, Gardasil protects against the two strains of HPV that cause the majority of cervical cancers. While males don't have a cervix to get cancer, they do have other parts that get HPV-related cancers (anal & penile, as well as some head and neck cancers,) although certainly these cancers are less common.

Gardasil was approved for use in males over two years ago, but the public has mainly been aware of the use in females. I'm glad the CDC and ACIP are on board, and hope that with increased education, we can help protect the next generation against HPV-related diseases.
BOTTOM LINE: Gardasil- it's not just for girls! Talk to your family doctor about immunizing ALL your kids.

PS. I am NOT on anyone's payroll for this vaccine- but I absolutely do recommend it.