USE OF HEAD LICE TREATMENTS IN PREGNANCY

Head lice (Pediculus humanus capitis) are parasitic insects that infest the hairs of the human head and feed on blood from the scalp. Head lice can be eradicated by ‘wet combing’ the lice and eggs from the hair with a fine-toothed comb and conditioner, using dimeticone-based treatments, or malathion, a chemical insecticide.

Exposure to topical head lice treatments would not be expected to cause fetal harm as they will not enter the maternal bloodstream in appreciable amounts.

The most commonly used topical head lice treatments are based on dimeticone (derived from silicone), an inert chemical widely found in antacid medications and cosmetics. There are no human pregnancy exposure data but adverse effects are not anticipated.

Malathion-based insecticide treatments for head lice are also available. There are two case reports of pregnancy outcomes following topical malathion use in pregnancy, with one malformed infant and one uneventful outcome described. Resistance to malathion has also been noted and it may be preferable, at least initially, to use other means to treat head lice during pregnancy.

Exposure to head lice treatments at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy or any additional fetal monitoring. However, other risk factors may be present in individual cases which may independently increase the risk of adverse pregnancy outcome. Clinicians are reminded of the importance of consideration of such factors when performing case-specific risk assessments.