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How safe are insecticidal lice shampoos?

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The easiest way to treat head lice is with chemical pesticides. But the use of these shampoos is controversial, and those containing lindane (gamma benzene hexachloride) has now been restricted in South Africa. This chemical is known to be neurotoxic, and there's also been a case of a South African child who developed aplastic anaemia after the use of one such shampoo.

Thanks to steps recently taken by the Medicines Control Council (MCC), these shampoos are now only indicated for the treatment of head lice, pubic lice and crab lice in people who are intolerant of, or who have failed to respond to other therapies. It's also been bumped up to schedule 2 status from schedule 1.

While in other parts of the world the use of these shampoos is banned completely, South Africa has at least taken a step in the right direction. Unfortunately, this also means that desperate parents are left with fewer options. It also highlights the fact that parents should be very cautious when treating their children for lice.

Read: Hot air zaps lice

What to do

If your child has head lice and you're concerned about using a lindane-containing shampoo, there are safer options:

- One is to choose a shampoo that's made with natural neem-seed extract. Research by Australian and Egyptian universities show that these shampoos are effective and safe. They're also now available in South Africa.

- Of the chemical shampoos out there, those that contain permethrin are generally regarded as the safest, even though research shows that the chemical might be carcinogenic.

If you're unsure of which option to choose, it's important to check with your doctor or pharmacist. Also make sure you follow the directions exactly as indicated on the label. Remember, these products are pesticides and applying too much, or too frequently, may increase the risk of causing harm.

To prevent a case of head lice, teach children not to share brushes, caps, towels and bedding.

Read more:

How to comb out head lice

Head lice myths busted

Head lice: know the facts

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