Leading Expert on Head Lice Urges Parents to Follow the Science When Treating Infestations

“Super Lice” Now Resistant to Most OTC Treatments

Carmel, IN – August 24, 2020 – Parents facing an infestation of resistant head lice, widely known to the general public as  “super lice”, now need to visit their health care provider first, in person or via telemedicine, says leading expert Dr. John Clark, as well as ParaPRO, a specialty pharmaceutical company focused on innovative anti-parasitic treatments. Due to the nearly universal prevalence of pyrethrin- and permethrin- resistant head lice, it is more important than ever that parents access treatments that are scientifically proven to be safe, fast-acting and effective at eradicating lice, especially as students prepare to return to school, and as families continue to live and interact in close quarters due to COVID-19.

“Several evidentiary studies, including a 16-year landmark study, have shown that 98.3% of the surveyed U.S. head lice have become genetically resistant to the over-the-counter (OTC) products containing either pyrethrin or permethrin as active ingredients,” said Dr. John Clark, professor of environmental toxicology and chemistry, and director of the Massachusetts Pesticide Analysis Laboratory at the University of Massachusetts Amherst. “While these products have dominated the market, insecticide resistance has occurred worldwide and is contributing to both the increased incidence of pediculosis and to unprecedented levels of treatment failure.”

Contrary to the abundance of clinical evidence demonstrating the lack of effectiveness of several leading OTC head lice shampoos and creme rinses, medical associations such as the American Academy of Pediatrics, and government agencies including the Centers for Disease Control have been slow to update their treatment guidelines and continue to recommend the use of pyrethrin- and permethrin-based OTC products as first-line agents. In addition, major U.S. pharmacy retailers continue to sell these OTC products further compounding the situation and resulting in the purchase of 3.45 million units annually even though their efficacy has been substantially reduced to no clinical effect due to resistance.1

Bill Culpepper, President of ParaPRO added, “In this unsettling time of COVID-19, families shouldn’t have to cope with any unnecessary health worries concerning their children, such as treatment failure for head lice or the potential side effects of multiple failed treatments. We urge parents and caregivers to follow the overwhelming genetic and clinical evidence, and to seek the advice of a licensed health professional when faced with any potential infestation with these all too common parasites.”

The Importance of Telemedicine
Parents concerned about accessing a health care professional regarding a head lice infestation have sensible options. Virtual visits to health care providers, including pediatricians, family practitioners and pediatric dermatologists, offer a great alternative to face-to-face office visits, especially during today’s nation-wide pandemic. Telemedicine enables parents and families to access expert advice from the comfort and safety of home, with the added benefits of reduced wait times and potential cost savings for payers and for the patients’ family.2

About “Super” Lice
Head lice are continuously evolving to adapt to their environment and have widely and uniformly developed knockdown resistance by acquiring kdr-type genetic mutations that render them resistant to the two most common OTC treatment formulations.3  Researchers hypothesize that patient self-diagnosis and patient misuse of these products have contributed to this increase in resistance, with one clinical analysis of patient use charts showing that the OTC head lice medications were applied five times on average, well beyond the recommended use.4  Continued exposure to insecticides such as permethrin and other pyrethroids can result in side effects ranging from headaches, dizziness, nausea, and seizures, to muscle tremors, abdominal pain, and other symptoms of neurotoxicity.5

About ParaPRO
ParaPRO LLC., a life-sciences organization dedicated to eradicating ectoparasites (bugs that live on the body surface), has developed a variety of diagnostic and educational tools to assist HCPs and parents in successfully identifying, managing and treating head lice infestations in children. For more information, visit ParaPRO.com/head-lice/.


  1. IRI – 52-week period ended April 21, 2020, Total US Drug and Total US Food.

  2. K Seiger, EB Hawryluk, D Kroshinsky, JC Kvedar, S Das. Pediatric Dermatology eConsults: Reduced Wait Times and Dermatology Office Visits. Pediatr Dermatol 2020 Jun 16;[EPub Ahead of Print]

  3. Gellatly KJ, Krim S, Palenchar DJ, et al. Expansion of the Knockdown Resistance Frequency Map for Human Head Lice (Phthiraptera: Pediculidae) in the United States Using Quantitative Sequencing. J Med Entomol. 2016;53(3):653‐659. https://academic.oup.com/jme/article/53/3/653/2222496

  4. West DP. Head lice treatment costs and the impact on managed care. Am J Manag Care. 2004;10(9 Suppl):S277‐82. https://www.ajmc.com/view/sep04-1894ps277-s282

  5. FDA Adverse Event Reporting System (FAERS) Quarterly Data Extract Files
  6. https://fis.fda.gov/extensions/FPD-QDE-FAERS/FPD-QDE-FAERS.html
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