title: Tocopheryl acetate 20% spray for elimination of head louse infestation: a randomised controlled trial comparing with 1% permethrin creme rinse.
abstract: BACKGROUND
  Tocopheryl acetate is viscous oily fluid used in a range of preparations for skin and scalp care in Italy. Observational and in vitro data have suggested a high level of efficacy against head louse infestation. The purpose of this investigation was to confirm the activity of tocopheryl acetate in a clinical setting in comparison with a standard widely used preparation.
  
  
  METHODS
  A spray formulation containing tocopheryl acetate 20% in cyclomethicone was compared with permethrin 1% creme rinse for treatment of head louse infestation in a randomised, assessor blind, trial. Forty-five people were treated on two occasions 7 days apart. The spray was applied to dry hair for 20 minutes then washed. Participants treated with permethrin washed their hair and towel dried it before treatment for 10 minutes. Assessments were made by dry detection combing 1, 6, 9, and 14 days after first treatment.
  
  
  RESULTS
  The tocopheryl acetate 20% spray was significantly (p = 0.033) more effective than permethrin 1%, using intention to treat worst case analysis, in which there were 13/23 (56.5%) successful treatments for tocopheryl acetate compared with 5/22 (22.7%) for permethrin. After unprecedented issues of re-infestation within households had been taken into account the underlying cure rate was 17/23 (73.9%) for tocopheryl acetate compared with 5/22 (22.7%), Odds Ratio 9.63 (95% CI, 2.46 to 37.68) (p < 0.001).
  
  
  CONCLUSIONS
  The tocopheryl acetate spray was significantly more effective than the permethrin product, was cosmetically acceptable, and not affected by current problems with resistance.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN45553737.
authors.affiliation: Medical Entomology Centre, Insect Research & Development Limited, Cambridge, UK. ian@insectresearch.com.
authors.forename: Ian F
authors.initials: IF
authors.lastname: Burgess
authors.forename: Nazma A
authors.initials: NA
authors.lastname: Burgess
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Brunton
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000336:Aerosols; D000818:Animals; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007306:Insecticides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010373:Lice Infestations / Q000188:drug therapy*; D008297:Male; D009824:Ointments; D010374:Pediculus / Q000187:drug effects*; D026023:Permethrin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012536:Scalp Dermatoses / Q000188:drug therapy*; D016037:Single-Blind Method; D016896:Treatment Outcome; D024502:alpha-Tocopherol / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000336:Aerosols; D007306:Insecticides; D009824:Ointments; D026023:Permethrin; D024502:alpha-Tocopherol