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Q. My grandchildren started scratching their heads several weeks ago. Upon careful examination, we discovered they had lice. Their parents have been diligent in using lice shampoo, combing out nits and washing the bedding, to no avail. Are there any more effective strategies besides over-the-counter lice shampoos?

A. Lice in the U.S. have developed some degree of resistance to insecticides such as permethrin and pyrethrin found in many OTC lice shampoos. Newer prescription treatments are effective but pricey. They include Ulesfia (benzyl alcohol), Sklice (ivermectin) and Natroba (spinosad). A treatment can run from $250 to $300.

Many visitors to our website report success with alternative approaches. Some drench the hair in old-fashioned amber Listerine for half an hour or so (wrapping the hair in a towel). The dead lice and nits are combed out.

Another option is Cetaphil Gentle Skin Cleanser. One reader shared her technique: “We put Cetaphil in dry hair, comb the excess out and then blow-dry the hair. We leave it in for at least 24 hours and then shampoo it out. We also comb to check for nits, and do a follow-up treatment seven days later to catch any bugs that hatched from eggs.”

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Q. When the prescription label says take before meals, what does that mean?

A. Such instructions are meaningless. You need to know if your medicine works best when taken on an empty stomach (at least an hour before eating or two hours after a meal) or with food. Ask your prescriber or pharmacist to provide detailed instructions for this specific drug.