title: Interventions for treating headlice.
abstract: BACKGROUND
  Infection with head lice is a widespread condition in developed and developing countries. Infection occurs most commonly in children, but also affects adults. If left untreated the condition can become intensely irritating and skin infections may occur if the bites are scratched.
  
  
  OBJECTIVE
  The aim of this review was to assess the effects of interventions for head lice.
  
  
  METHODS
  Trials register of The Cochrane Infectious Diseases Group; Medline; Embase; Science Citation Index; Biosis and Toxline; reference lists of relevant articles; pharmaceutical companies producing pediculicides (published and unpublished trials); UK and US Regulatory Authorities.
  
  
  METHODS
  Randomised trials (published and unpublished) or trials using alternate allocation were sought which compared pediculicides with the same and different formulations of other pediculicides, and pediculicides with physical methods.
  
  
  METHODS
  Of the 71 identified studies, only four met the inclusion criteria. Two reviewers independently assessed trial quality. One reviewer extracted the data.
  
  
  RESULTS
  We found no evidence that any one pediculicide has greater effect than another. The two studies comparing malathion and permethrin with their respective vehicles showed a higher cure rate for the active ingredient than the vehicle. Another study comparing synergised pyrethrins with permethrin showed their effects to be equivalent. A comparative trial of malathion lotion vs combing, showed combing to be ineffective for the cureative treatment of head lice infection. Adverse effects were reported in a number of trials and were all minor, although reporting quality varied between trials.
  
  
  CONCLUSIONS
  Permethrin, synergised pyrethrin and malathion were effective in the treatment of head lice. However, the emergence of drug resistance since these trials were conducted means there is no direct contemporary evidence of the comparative effectiveness of these products. The 'best' choice will now depend on local resistance patterns. Physical treatment methods(BugBusting) were shown ot be ineffective to treat head lice. No evidence exists regarding other chemical control methods such as the use of herbal treatments, when used in the curative treatment of head lice. Future trials should take into account the methodological recommendations that arise from this review.
authors.affiliation: Medical Entomology Centre, Cambridge Road, Fulbourn, Cambridge, UK, CB1 5EL.
authors.forename: C S
authors.initials: CS
authors.lastname: Dodd
mesh_terms: D000328:Adult; D000818:Animals; D000977:Antiparasitic Agents / Q000627:therapeutic use; D012721:Carbaryl / Q000627:therapeutic use; D006266:Health Education; D006801:Humans; D006920:Hygiene; D010373:Lice Infestations / Q000517:prevention & control / Q000628:therapy*; D008294:Malathion / Q000627:therapeutic use; D010374:Pediculus; D026023:Permethrin; D008517:Phytotherapy; D011722:Pyrethrins / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012536:Scalp Dermatoses / Q000517:prevention & control / Q000628:therapy*
chemical_list: D000977:Antiparasitic Agents; D011722:Pyrethrins; D026023:Permethrin; D012721:Carbaryl; D008294:Malathion