Ethics questions arise after doctor reveals `secret' head lice treatment.

Byline: Tim Christie The Register-Guard

Dr. Dale Pearlman said he was hoping to make "a million bucks" when he devised a better louse trap to defeat head lice. But when no one beat a path to his door, he decided to reveal his secret.

His treatment: Apply Cetaphil Gentle Cleanser - a widely sold, soap-less cleanser - liberally to lice-infested hair, comb out the excess, and blow dry to suffocate lice under the lotion. Repeat once a week for three weeks.

That's it. No pesticides. No nitpicking. No daily vacuuming or endless laundry. Pearlman revealed the secret of his treatment Monday in a letter published in the journal Pediatrics. But some medical ethicists said he should have come clean earlier.

The Menlo Park, Calif., dermatologist first reported on his treatment in Pediatrics in September 2004, based on research he did in his clinic. The treatment proved to be 96 percent effective when used on 133 patients, he said. After six months, only 6 percent of the patients had a re-infestation, he said.

He described the method, but didn't identify the lotion, referring to it as a secret formula called "Nuvo."

Pearlman said he got hundreds of e-mails and phone calls from people wanting to buy Nuvo, but didn't disclose his secret because he wanted to cash in. He was unable, however, to interest pharmaceutical companies in developing a lice-specific lotion similar to Cetaphil because the market for lice treatment products isn't big enough, he said.

"I hoped to get rich, and I'm sorry I didn't," he said. But, he added, he's happy now to reveal what he describes as the "world answer to head lice."

"It's so rare in life that one has an opportunity to do something good for the world," he said.

Some medical ethicists are critical of Pearlman, however, for not disclosing that "Nuvo" was in fact an over-the-counter skin cleanser.

University of Minnesota medical ethicist Dr. Jeffrey Kahn said he found Pearlman's failure to disclose his product's true identity until now troubling.

"He seems to imply that you could do it yourself" - something patients would have wanted to know, as well as doctors and Pediatrics' peer reviewers who read last year's study, Kahn said. "You don't pull tricks on your colleagues and the peer review."

Leonard Fleck, a Michigan State University medical ethicist, said Pearlman's lack of disclosure in the original study made it impossible for other scientists to test his methods.

"At the very least there's deception there for reasons of self-interest," Fleck said.

Dr. Jerold Lucey, Pediatrics' editor, called Pearlman "a bit of a huckster" and said that, in hindsight, when Pearlman submitted his study, "I probably would have said: `We can't publish this if you can't tell us what it is.' "

However, said Lucey, "You've got to give him points for writing" to set the record straight.

Head lice are parasitic insects that feed on the blood of people.

Infestation is common - preschool and elementary age children, age 3 to 11, are infested most often - but no reliable statistics exist on how many people get head lice in the United States each year, according to the U.S. Centers for Disease Control and Prevention.

Parents turn to various over-the-counter and prescription remedies, but they don't always work. And some parents who don't like the idea of using pesticides try various folk remedies, slathering mayonnaise, peanut butter or olive oil on their children's heads to try to smother the bugs.

Pearlman took the concept one step further. Applying the lotion and blow drying it on suffocates the lice, and there's no worry the treatment will rub off. Also, he said, the lotion is aesthetically acceptable, unlike, say, peanut butter or mayonnaise.

"When this stuff is dried on, it's undetectable," he said, though the hair is a little bit stiff.

What Pearlman also found, he said, is that the housecleaning associated with lice treatment is unnecessary because it had no influence on whether the lice were eradicated.

"Extensive household cleanup is irrelevant," he said.

He said he also found there's no reason to pick nits, that is, remove the tiny louse eggs that stick to hair. If people do the treatment once a week for three weeks, any nits that hatch will be killed by the treatment before they reproduce, he said.

Whether Pearlman's treatment catches on remains to be seen. Dr. Karen Weiner, a Eugene pediatrician, said she sometimes suggests peanut butter or mayonnaise as nontoxic treatments for parents who don't want to use pesticides.

Pearlman's treatment "would be something in my arsenal I would talk to families about," she said. "Any nontoxic product that is shown to kill lice is good news from my perspective."

Brent Petersen, communications manager for Cetaphil's maker, Galderma Laboratories of Fort Worth, Texas, called Pearlman's tactics `a bit misleading' and said the company knew nothing about Pearlman's use of Cetaphil until learning of his letter.

`We'll obviously look into it,' Petersen said.

He said Cetaphil's label clearly states that it is a skin cleanser and that Galderma has no data confirming or denying that it is an effective head lice treatment.

One note of caution: Anyone using the prescription drug malathion, sold under the Ovide label, to treat head lice should not borrow Pearlman's hair dryer method. The CDC warns that malathion is flammable and should be kept away from heat sources.

The Associated Press contributed to this report.

LICE BE GONE

Dr. Dale Pearlman's treatment for head lice is simple, but he said it's important to follow his protocol closely for success.

For detailed instructions and information, go to his Web site: www.nuvoforheadlice.com.

For more information on head lice, go to the Centers for Disease Control and Prevention Web site: www.cdc.gov/ncidod/dpd/parasites/lice/default.htm