Over-the-counter Pediculus humanus capitis treatment: The nit comb is not appropriate for all hair types!

Biological diversity of hair affects what stress the hair can withstand. This proves to create a gap in care when evaluating over-the-counter (OTC) products available to treat Pediculus humanus capitis (head lice) in the United States. The nit comb would not be conducive for use in an individual with African hair, yet all OTC product instructions list the requirement of the nit comb. Lice treatment products provide instructions that are applicable for only specific hair types and do not address treatment recommendations for African hair. The OTC product instructions are outdated and exclusionary. A clear discrepancy and gap in care exist for many Americans seeking self-care treatment of pediculosis capitis. Pharmacists should remain aware of this discrepancy and counsel on alternative practices such as applying the active formulations in the hair but refrain from using the nit comb following the application of the topical medication.

Key Points
Background

•  It is estimated that between 6 and 12 million head lice infestations occur each year in the United States in children between the ages of 3 and 11 years.
•  Cases of Pediculus humanus capitis are less common among African Americans than other races.

Findings

• The nit comb can't be used in all hair types, but hair types are not addressed in package inserts nor in guideline recommendations.
• A clear discrepancy and gap in care exist for many Americans seeking self-care treatment of pediculosis capitis.
• Hair types should be addressed and considered when deciding treatment strategies, including the fact that nit combs are not appropriate for all hair types.