Treatment of head louse infestation with 4% dimeticone lotion: randomised controlled equivalence trial

Abstract

Objective To evaluate the efficacy and safety of 4% dimeticone lotion for treatment of head louse infestation. Design Randomised controlled equivalence trial. Setting Community, with home visits. Participants 214 young people aged 4 to 18 years and 39 adults with active head louse infestation. Interventions Two applications seven days apart of either 4.0% dimeticone lotion, applied for eight hours or overnight, or 0.5% phenothrin liquid, applied for 12 hours or overnight. Outcome measures Cure of infestation (no evidence of head lice after second treatment) or reinfestation after cure. Results Cure or reinfestation after cure occurred in 89 of 127 (70%) participants treated with dimeticone and 94 of 125 (75%) treated with phenothrin (difference − 5%, 95% confidence interval − 16% to 6%). Per protocol analysis showed that 84 of 121 (69%) participants were cured with dimeticone and 90 of 116 (78%) were cured with phenothrin. Irritant reactions occurred significantly less with dimeticone (3/127, 2%) than with phenothrin (11/125, 9%; difference − 6%, − 12% to − 1%). Per protocol this was 3 of 121 (3%) participants treated with dimeticone and 10 of 116 (9%) treated with phenothrin (difference − 6%, − 12% to − 0.3%). Conclusion Dimeticone lotion cures head louse infestation. Dimeticone seems less irritant than existing treatments and has a physical action on lice that should not be affected by resistance to neurotoxic insecticides.

Clinical efficacy and safety in head lice infection byPediculus humanis capitisDe Geer (Anoplura: Pediculidae) of a capillary spray containing a silicon-oil complex

“…this may explain the 13 % of failures at d1. this study confirms the results obtained in the two other studies (randomised controlled trials) evaluating a dimethicone-based non-conventional treatment, which reported 70 % of cure (no evidence of head lice) after two overnight applications of 4 % dimethicone lotion seven days apart (Burgess et al, 2005(Burgess et al, , 2007. But, our results are less than those obtained by heukelbach et al…”

“…Mémoire Parasite, 2010, 17, 329-335 problems to ensure that hair and scalp had been well covered, in particular in girls or women with long and thick hair (Burgess et al, 2005). obviously, an insufficient amount of product applied is a common cause of therapeutic failure (chosidow, 2000).…”

“…however, their efficacy, assessed in studies with design and methodology of questionable quality (dawes, 2005; roberts et al, 2005; chosidow, 2006), remains to be established. nevertheless, Burgess in recent studies evaluated the efficacy of a new dimethicone-based product without conventional insecticide activity compared with phenothrin (Burgess et al, 2005(Burgess et al, , 2007. Its mode of action was based on the coating and irreversible immobilisation of lice, leading to their drowning (Burgess, 2009).…”

Headlice eradication as everyday engagement with science: An analysis of online parenting discussions

“…However, different means of treatment depend on different aspects of the biology of headlice, and in order to choose between options in an informed fashion and to operate the chosen solution effectively it may be very useful to know something of this biology. It may be useful, for example, to distinguish between systemic pesticides with neurotoxic action and silicone-based treatments that physically affect the ability of lice to acquire oxygen or excrete water, because lice are held to be less likely to become resistant to the latter (Burgess et al 2005). In timing repeat treatments with pesticide or physical removal by combing it may help to know the length of the life cycle of lice in terms of egg hatching and maturation of larvae.…”

The near future of head louse control

“…Some of them are also fully ovicidal so a single treatment would be enough to eliminate the head louse population on the head of an infected individual. A large number of clinical trials were conducted and showed that most of them are highly effective and do not cause any significant side effects [5][6][7][8][9][10] .…”