An over-the-counter skin cleanser may have potential in treating head lice, according to a recent disclosure from a California dermatologist.
Dr. Dale L. Pearlman of Menlo Park, Calif., announced in December that the dry-on suffocation pediculicide (DSP) lotion he used in a study published in Pediatrics in 2004 was in fact the over-the-counter cleanser Cetaphil, marketed by Galderma Laboratories (Pediatrics 2004;114:e275–9).
Dr. Pearlman made the announcement in a letter to the editor of Pediatrics that was published in December 2005. In the letter, he said that he was making the disclosure so that physicians could try the treatment on their own (Pediatrics 2005;116:1612).
“I have received [more than] 250 requests from health care practitioners from the United States and abroad for additional information about this treatment; however, no pharmaceutical company, university, or health care entity has stepped forward to perform such studies,” Dr. Pearlman wrote in the letter.
“I now have realized that practitioners who want independent information will need to try out the treatment themselves,” he continued.
In the 2004 article in Pediatrics, Dr. Pearlman detailed the ingredients of the Cetaphil cleanser, which he referred to as “Nuvo lotion.” However, he did not say that it was already available over the counter. A 16-oz. bottle of Cetaphil generally sells for about $10.
The 2004 study showed that the DSP lotion was overall 96% effective and had a 94% overall long-term cure rate. Patients in the study received a once-weekly application of the DSP lotion for up to 3 weeks until cure was achieved.
Dr. Pearlman's protocol called for parents to apply the lotion and wait 2 minutes, then comb out as much lotion as possible.
Next, the protocol called for the child's hair to be thoroughly dried with a handheld hair dryer. The lotion is washed out with the child's regular shampoo in 8 hours or more.
The study was a preliminary proof of concept trial, Dr. Pearlman said in an interview, and he never meant for the public at large to be using the Cetaphil cleanser for the treatment of head lice.
Instead, Dr. Pearlman had hoped that a pharmaceutical company would sign on to study the idea and possibly make improvements to the formulation that would allow for quick drying and include a fluorescent tag to allow for independent confirmation that a child had been treated.
Dr. Pearlman said he's been up front with parents and colleagues from the beginning.“My work exemplifies the highest ethical standards for the medical profession,” he said. “The way has always been open for others to repeat my work.”
For 7 years, he provided his time and the treatment to patients at no cost, but this year he began to charge patients for his professional time and the cost of materials, which includes $40 worth of Cetaphil cleanser, three diagnostic tests for head lice, and an office visit.
So far, feedback from parents whose children were part of the study has been positive, he said. “They've all been very encouraging.” Dr. Pearlman said he suspects that more physicians will want to try his method.
Officials at Galderma said that the company has no plans to seek Food and Drug Administration approval to market the skin cleanser as a treatment for head lice, said Brent Petersen, a spokesman for the company.
While it's an “interesting concept,” Mr. Petersen said that Galderma will continue to promote the product as a gentle skin cleanser.
And Mr. Petersen said that while it was “a bit misleading” for Dr. Pearlman to call the cleanser Nuvo lotion, he was in no legal trouble for using the product in his study.