What is the role of pesticides in the treatment of pediculosis and pthiriasis (lice infestation)?

Updated: Aug 16, 2019
  • Author: Lyn C C Guenther, MD, FRCPC, FAAD; Chief Editor: Michael Stuart Bronze, MD  more...
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Various topical pediculicidal agents are available for the treatment of head and pubic lice. Pyrethrins with piperonyl butoxide (A-200, Pronto, R&C, Rid, Triple X), permethrin 1% lotion (NIX), dimethicone (LiceMD Pesticide Free) and mineral oil–based products (Nix Ultra shampoo) are available over the counter; malathion 0.5% (Ovide), lindane 1% shampoo and lotion, ivermectin 0.5% lotion (Sklice), spinosad 0.9% (Natroba), and benzyl alcohol 5% lotion (Ulesfia) are prescription agents.

Pubic lice can be treated with over-the-counter permethrin 1% lotion and a mousse containing pyrethrins and piperonyl butoxide (RID foam). [13] Lindane shampoo (1%) is FDA approved as second-line treatment of pubic lice (crabs). Dimethicone, malathion, ivermectin, spinosad, and benzyl alcohol are currently not US Food and Drug Administration (FDA) approved to treat pubic lice.

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