Abstract
The rate of head louse infestations is increasing. Most of the neurotoxic treatments are not reliably ovicidal and are faced with genetic resistance. The treatments based on a mechanical mode of action show no sufficient efficacy, transferring the chances of a cure on a tedious combing or leaving the hair fatty. This double-blinded, randomized, controlled, superiority trial evaluates the efficacy and safety of a novel mixture made of semi-crystalline polymers and plant extracts. Forty-five participants received a single application of either 1% Permethrin lotion or the novel lotion, applied for 15 minutes. Untreated and treated nits were collected and placed in an incubator during 10 days. The worst case intent-to-treat analysis found the novel lotion significantly more effective than 1% Permethrin, with 21/22 (95.5%) participants cured and 9/23 (39.1%), respectively (p < 0.0001). Rate of viable nymphs was 0.5 (2.1) for the new lotion and 40.8 (20.4) for the 1% Permethrin. The new lotion cures head louse infestations, offering an effective alternative treatment, with a high efficacy for inhibiting the hatching of eggs. Its physical actions on lice and their eggs should not be affected by resistance to neurotoxic insecticides.
Highlights
Head louse infestations are frequent among children 3–11 years of age and may induce skin irritation, superinfection from scratching, social stigmatization, and psychological distress [1]
Results highlight an effect of the degree of infestation: a heavy infestation divides the risk of healing by 1/0.077 = 13, 1/0.062 = 16, or 1/0.059 = 17, depending on the samples considered, regardless of the treatment
This study has shown that a single application of the new lotion made by semi-crystalline polymers and plant extracts is effective to eliminate in 15 min head louse infestation and to inhibit eggs hatching
Summary
Head louse infestations are frequent among children 3–11 years of age and may induce skin irritation, superinfection from scratching, social stigmatization, and psychological distress [1]. Head louse infestations cause high levels of anxiety among the parents of school-aged children [2]. The first generation of anti-lice treatments, developed from the forties, has a neurotoxic action. Those treatments are essentially composed by organophosphate insecticides (malathion) and by pyrethroids (e.g., pyrethrins, phenothrin, and permethrin). Permethrin 1% lotion is still the first-line pharmacologic treatment of pediculosis. Those treatments, registered as drugs, are still preponderant in the United States and South America markets but not commonly used in Europe
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