For all parents who have ever sat for hours picking nits out of their child's hair -- yes, yours truly -- an expanded arsenal to treat stubborn hair lice is a welcome relief. There's now a prescription remedy called Natroba (spinosad), which was approved on Tuesday by the Food and Drug Administration for kids four years and older.
FDA spokesperson Shelly Burgess tells me that it kills eggs as well as lice, so no nit-picking necessary. There's already another prescription treatment -- called Ovide (malathion) -- that doesn't require egg removal, but many parents, myself included, have shied away from using it because it's very flammable. The manufacturer recommends keeping kids away from heat sources like hair dryers and radiators for the 8 to 12 hours that the lotion is kept on the head.
Over-the-counter remedies like Nix and Rid have become less effective over the years as lice have become more resistant to them. But they're still pretty good as a first-line treatment, according to the Mayo Clinic, as long as you're willing to manually remove the nits, which aren't killed by the treatments.
Natroba -- expected to become available in the next few months -- was tested in a manufacturer-sponsored clinical trial involving 552 lice-ridden volunteers who received either a 10-minute treatment with the new product or a 10-minute treatment with Nix followed by a round of nit-picking. If live lice were seen a week later, a second treatment was applied. After two weeks, about 86 percent of the Natroba group was lice-free compared with 44 percent of the control group.
(I suppose those with persistent cases would then go on to try Ovide or lindane, another prescription treatment that's typically used as a last resort because of a small risk of neurological side effects.)
Natroba uses a soil fermentation product to kill the lice, but it also contains benzyl alcohol, which suffocates them. Benzyl alcohol could cause redness or irritation of the eyes and skin, and its safety hasn't been established in those under four years of age, according to the FDA.
The most commonly occurring side effects in the clinical trial included skin redness in 3 percent of the Natroba users versus 7 percent of the Nix users and eye redness and irritation which occurred in 2 percent of the Natroba users compared to 3 percent of Nix users.
For more details on dealing with lice, check out this video and Globe magazine story.
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