title: The efficacy of Australian essential oils for the treatment of head lice infestation in children: A randomised controlled trial.
abstract: BACKGROUND
  The increase in resistance of head lice to neurotoxic pediculicides and public concern over their safety has led to an increase in alternative treatments, many of which are poorly researched or even untested.
  
  
  METHODS
  A multicentre, randomised, assessor-blind, parallel-group trial (Trial 1) was conducted to compare the safety and efficacy of a head lice treatment containing Australian eucalyptus oil and Leptospermum petersonii (EO/LP solution; applied thrice with 7-day intervals between applications) with a neurotoxic treatment containing pyrethrins and piperonyl butoxide (P/PB mousse; applied twice with a 7-day interval) in children. A single-blind, open trial (Trial 2) was conducted to assess the efficacy of EO/LP solution following a single application. In addition, skin irritancy and sensitisation tests using EO/LP solution were performed in adults and children. In vitro tests were performed to further assess the ovicidal and pediculicidal efficacy of EO/LP solution.
  
  
  RESULTS
  EO/LP solution was found to be more than twice as effective in curing head lice infestation as P/PB mousse in per-protocol participants (Trial 1; 83% vs 36%, P < 0.0001), and was also found to be 100% pediculicidal following a single application (Trial 2). Adverse events were limited to transient itching, burning or stinging. Further skin testing with the EO/LP solution reported no irritation or sensitisation in adults, or irritation in children. In vitro exposure of lice and eggs to the EO/LP solution resulted in 100% mortality.
  
  
  CONCLUSIONS
  The efficacy, safety and relative ease of use of the EO/LP solution make it a viable alternative in treating head lice.
authors.affiliation: Ego Pharmaceuticals, Braeside, Victoria, Australia.
authors.forename: Kerryn A
authors.initials: KA
authors.lastname: Greive
authors.affiliation: Ego Pharmaceuticals, Braeside, Victoria, Australia.
authors.forename: Tanya M
authors.initials: TM
authors.lastname: Barnes
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D002675:Child, Preschool; D005052:Eucalyptus; D005260:Female; D006801:Humans; D007223:Infant; D007306:Insecticides / Q000627:therapeutic use; D031649:Leptospermum; D010373:Lice Infestations / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009822:Oils, Volatile / Q000009:adverse effects / Q000627:therapeutic use*; D010063:Ovum / Q000187:drug effects; D010374:Pediculus / Q000187:drug effects; D010574:Pesticide Synergists / Q000627:therapeutic use; D010882:Piperonyl Butoxide / Q000627:therapeutic use; D010938:Plant Oils / Q000009:adverse effects / Q000627:therapeutic use*; D011722:Pyrethrins / Q000627:therapeutic use; D012536:Scalp Dermatoses / Q000000981:diagnostic imaging* / Q000469:parasitology; D016037:Single-Blind Method
chemical_list: D007306:Insecticides; D009822:Oils, Volatile; D010574:Pesticide Synergists; D010938:Plant Oils; D011722:Pyrethrins; D010882:Piperonyl Butoxide
keywords: eucalyptus oil; head lice; lemon tea tree oil; piperonyl butoxide; pyrethrin; resistance