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Updated: May 2, 2026

Bioassays for Monitoring Insecticide Resistance
Published on: December 31, 2010
Clinical evidence of lice resistance to over-the-counter products
1Department of Medicine, Medical College of Ohio, Toledo, Ohio, USA.
Background:
Over-the-counter insecticidal solutions continue to be the mainstream treatment for most cases of head lice. Recorded insecticidal activity 15 years ago was at 100%, with ovicidal kill at 80%. Recently scattered accounts of possible resistance have surfaced.
Objective:
This article is to document the general consensus that head lice are becoming resistant to standard over-the-counter therapies.
Methods:
Direct testing of lethality of adult lice with permethrin and pyrethroid was assessed.
Results:
Present over-the-counter products proved to be successful in only 9 of 32 head lice tested (28% insecticidal activity).
Conclusions:
Our series of cases further documents that over-the-counter head lice preparations no longer achieve high levels of insecticidal activity, suggesting increased resistance to these insecticides.
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