Surprise revelation: Dermatologist's novel head lice treatment is an OTC skin wash

After an unsuccessful attempt to persuade pharmaceutical companies to fund further research on a head lice treatment he says he discovered and developed, dermatologist Dale Pearlman, MD, has revealed that the treatment is actually a brand-name over-the-counter skin cleanser.

In a letter to the editor published in the December 2005 issue of Pediatrics, Dr. Pearlman, of Menlo Park, Calif., reported that soaking the hair and scalp of a person who has head lice with Cetaphil Gentle Skin Cleanser (Galderma), then drying it in place with a hair dryer, suffocates lice by blocking their breathing apertures.

Dr. Pearlman's original research, in which he claimed a 96% cure rate with a product he called Nuvo, was published in the September 2004 issue of Pediatrics.

"I did not specify the commercial source of the lotion in the (2004) study because I viewed it simply as a prototype for use in a 'proof of concept' trial," Dr. Pearlman said. "I never anticipated that the public would use this prototype in the future as a treatment of head lice. While the prototype worked to cure lice, it had a major drawback—it took a very, very long time to dry. To be commercially viable it needed to be quick-drying. I hoped that by publishing the 2004 article, and thus making public the 'proof of concept' study, a pharmaceutical company would come along to develop a commercially attractive version of Nuvo lotion."

That didn't happen. Dr. Pearlman said that, although several pharmaceutical companies thought his idea was a good one, the market for head lice products was too small to justify the cost of research and development and marketing. All declined to fund further research.

"I realized that the only way the public was going to get a lotion to use in the Nuvo method was going to be via the prototype," Dr. Pearlman said, "so I made public the identity of the prototype lotion [in the December issue of Pediatrics]."

Media response to his letter was harsh. A December 5 Associated Press article quoted Dr. Pearlman as saying he didn't disclose the true identity of his Nuvo lotion at first "because I wanted to get rich." The article also quoted Michigan State University medical ethicist Leonard Fleck, who offered an opinion that "at the very least, there's deception there for reasons of self-interest."

In response, Dr. Pearlman said that physicians often use medications in a variety of ways, and that off-label use of products is well known in dermatology.

"My work exemplifies the highest ethical standards of the medical profession," he said. "The real formula for the Nuvo lotion prototype was included in the 2004 article. This exact formula can be found in both branded and generic skin cleansers readily available in pharmacies, so the way has always been open for others to repeat my work. I have encouraged others to independently do clinical trials using the Nuvo method of treatment.… I made this information [regarding Cetaphil Gentle Skin Cleanser] available to simplify the care of head lice in the U.S. and around the world. I derive no revenue from these sales of Cetaphil Gentle Skin Cleanser."