In the JournalsPerspective

Ivermectin effective for head lice treatment

Treatment of head lice infestation with topical ivermectin was well tolerated and efficacious in children aged as young as 6 months, according to new study data.

A single application of 0.5% ivermectin lotion (Sklice, Sanofi-Pasteur) administered at home was more effective than an identical formulation without ivermectin (vehicle control) in eliminating head-louse infestations at 1, 7 and 14 days after treatment.

“We found that 94.9% of ivermectin-treated patients were louse-free 1 day after application,” David M. Pariser, MD, of the department of dermatology at Eastern Virginia Medical School in Norfolk, Va., and colleagues wrote in the study conclusion.

Seven hundred sixty-five patients completed the two studies from March to July 2010 at eight separate sites per study. Those considered eligible included healthy patients aged at least 6 months with head-louse infestation who agreed not to use any other louse treatment; comb out nits; cut their hair; or chemically treat hair during the study, according to study details. On day 1, a tube of topical ivermectin or vehicle was applied to dry hair, left on for 10 minutes, and then rinsed with water.

The investigators reported that more than 94% of patients who received ivermectin were louse-free on day 2 vs. 31% in the control group. This trend continued for the ivermectin group on day 8 (85.2% vs. 20.8%) and day 15 (73.8% vs. 17.6%; P<.001 for each comparison). The frequency and severity of adverse events were similar in the two groups.

Disclosure: This study was funded by Sanofi-Pasteur. Pariser reports no relevant financial disclosures.

Treatment of head lice infestation with topical ivermectin was well tolerated and efficacious in children aged as young as 6 months, according to new study data.

A single application of 0.5% ivermectin lotion (Sklice, Sanofi-Pasteur) administered at home was more effective than an identical formulation without ivermectin (vehicle control) in eliminating head-louse infestations at 1, 7 and 14 days after treatment.

“We found that 94.9% of ivermectin-treated patients were louse-free 1 day after application,” David M. Pariser, MD, of the department of dermatology at Eastern Virginia Medical School in Norfolk, Va., and colleagues wrote in the study conclusion.

Seven hundred sixty-five patients completed the two studies from March to July 2010 at eight separate sites per study. Those considered eligible included healthy patients aged at least 6 months with head-louse infestation who agreed not to use any other louse treatment; comb out nits; cut their hair; or chemically treat hair during the study, according to study details. On day 1, a tube of topical ivermectin or vehicle was applied to dry hair, left on for 10 minutes, and then rinsed with water.

The investigators reported that more than 94% of patients who received ivermectin were louse-free on day 2 vs. 31% in the control group. This trend continued for the ivermectin group on day 8 (85.2% vs. 20.8%) and day 15 (73.8% vs. 17.6%; P<.001 for each comparison). The frequency and severity of adverse events were similar in the two groups.

Disclosure: This study was funded by Sanofi-Pasteur. Pariser reports no relevant financial disclosures.

    Perspective
    Edward A. Bell

    Edward A. Bell

    It is likely that data from this study were used in support of the recent labeling by the FDA for ivermectin 0.5% topical lotion (Sklice, Sanofi Pasteur) use in children aged 6 months of and older. This product adds to the pharmacotherapeutic armamentarium that prescribers now have when treating infestation with head lice. Although direct comparative trials are not available, clinicians can also choose from other FDA-labeled topical products, including malathion lotion (Ovide, Taro), benzyl alcohol lotion (Ulesfia, Shionogi), or spinosad suspension (Natroba, ParaPRO/Pernix Therapeutics), and can likely expect similar efficacy. 

    Differences among these products do exist. Advantages of ivermectin lotion include a good efficacy profile, labeling in ages as young as 6 months, and some ovicidal activity (with the potential for the necessity of one treatment only). A disadvantage includes ivermectin lotion’s relative higher cost.

    • Edward A. Bell, PharmD, BCPS
    • Infectious Diseases in Children Editorial Board

    Disclosures: Bell reports no relevant financial disclosures.