Head lice have been the bane of public health and school nurses since time immemorial. The high rate of transmission and the close proximity of children in school have made it a perennial problem. The age-old issue has prompted many interesting therapies over the years, partly because the problem existed long before the advent of our newer medications. It has also spawned a collection of eradication procedures that are more based on dogma than scientific merit.

The challenge of defeating the wily Pediculosis is its life cycle. The nits are laid at the base of the hair, and are encased in a protective cement which makes it almost impossible to scrape them away without fracturing the hair. Since most conventional treatments are essentially neurotoxins, only the nymphs and adults are susceptible to permethrins and malathion. Furthermore, there’s emerging resistance to these agents. Nit combing has very high failure rates, due mainly to the very high time commitment and labour involved in combing properly.

In your case of applying sulphur with petrolatum and Cetaphil, the only active ingredient is the Cetaphil. The petrolatum can obstruct the respiratory spicules, but overall is a poor regimen.

A more recent development is the use of a detergent, isopropyl myristate, in a cream rinse. The lice are subject to dehydration if the exoskeleton is damaged. The detergent dissolves the chitin, and the lice dehydrate. Best of all, there’s no emerging resistance to the treatment, as no enzymes are needed. A reapplication is necessary after 7 days to treat the hatched nymphs. This reapplication at one week also prevents the nymphs from laying any new nits.

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