Evaluating the Efficacy of Therapeutic Interventions for Head Lice: A Systematic Review
DOI:
https://doi.org/10.22100/ijhs.v12i1.1271Keywords:
Head lice, Pediculus humanus capitis, Systematic review, Treatment, Clinical trialAbstract
Background: Pediculosis remains a significant public health concern in many communities. Head lice infestations and their management continue to pose both clinical and social challenges. This systematic review aimed to evaluate the efficacy of various therapeutic interventions for head lice, focusing on their effectiveness in eradicating infestations.
Methods: A systematic search was conducted in databases PubMed, Web of Science, and Scopus for studies published between 2013 and 2023, using the keywords Head lice, Pediculus humanus capitis, Pediculosis, and Treatment. Randomized or controlled trials with at least minimal blinding and participants aged over six months were included. Study selection and data extraction were performed independently by two reviewers.
Results: A total of 21 studies involving 3,232 participants met the inclusion criteria. Treatments were classified into chemical and non-chemical categories. Among chemical treatments, permethrin, dimethicone, ivermectin, and phenothrin were the most effective. Effective non-chemical interventions included natural oils and plant-based extracts such as eucalyptus. Reported treatment success rates showed considerable variability, ranging from 20% to 100%.
Conclusions: Pediculosis remains highly prevalent worldwide. Although various treatment options are available, selecting the most effective and least harmful intervention based on individual and regional factors is essential for optimal management.
References
Leung AKC, Lam JM, Leong KF, Barankin B, Hon KL. Paediatrics: how to manage pediculosis capitis. Drugs Context 2022;11. doi: 10.7573/dic.2021-11-3
Hatam-Nahavandi K, Ahmadpour E, Pashazadeh F, et al. Pediculosis capitis among school-age students worldwide as an emerging public health concern: a systematic review and meta-analysis of past five decades. Parasitology Research 2020/10/01 2020;119(10):3125-3143. doi: 10.1007/s00436-020-06847-5
Amanzougaghene N, Fenollar F, Raoult D, Mediannikov O. Where Are We With Human Lice? A Review of the Current State of Knowledge. Review. Frontiers in Cellular and Infection Microbiology 2020;Volume 9 - 2019. doi: 10.3389/fcimb.2019.00474
Pérez-Gaxiola G, Velásquez-Salazar P, Veroniki AA, et al. Interventions for treating head lice: a network meta‐analysis. Cochrane Database Syst Rev 2022;2022(9). doi: 10.1002/14651858.CD014735
Sara W, Hilde L, Nele H, Inge P, Jean-Marie N, Jan De M. The importance of socio-economic status and individual characteristics on the prevalence of head lice in schoolchildren. European Journal of Dermatology 2005;15(5):387-392.
Moosazadeh M, Afshari M, Keianian H, Nezammahalleh A, Enayati AA. Prevalence of Head Lice Infestation and Its Associated Factors among Primary School Students in Iran: A Systematic Review and Meta-analysis. Osong Public Health Res Perspect Dec 2015;6(6):346-56. doi: 10.1016/j.phrp.2015.10.011
Madke B, Khopkar U. Pediculosis capitis: an update. Indian journal of dermatology, venereology and leprology 2012;78:429-438. doi: 10.4103/0378-6323.98072
Fu Y-T, Yao C, Deng Y-P, et al. Human pediculosis, a global public health problem. Infectious Diseases of Poverty 2022;11(1):58. doi: 10.1186/s40249-022-00986-w
Kitvatanachai S, Kritsiriwutthinan K, Taylor A, Rhongbutsri P. Head Lice Infestation in Pre-High School Girls, Lak Hok Suburban Area, Pathum Thani Province, in Central Thailand. Journal of Parasitology Research 2023;2023(1):8420859. doi: 10.1155/2023/8420859
Falagas ME, Matthaiou DK, Rafailidis PI, Panos G, Pappas G. Worldwide prevalence of head lice. Emerging infectious diseases 2008;14(9):1493. doi: 10.3201/eid1409.080368
Patel PU, Tan A, Levell NJ. A clinical review and history of pubic lice. Clinical and Experimental Dermatology 2021;46(7):1181-1188. doi: 10.1111/ced.14666
Verma P, Namdeo C. Treatment of Pediculosis Capitis. Indian Journal of Dermatology 2015;60(3):238-247. doi: 10.4103/0019-5154.156339
Burkhart CG, Burkhart CN. Safety and efficacy of pediculicides for head lice. Expert Opinion on Drug Safety 2006;5(1):169-179. doi: 10.1517/14740338.5.1.169
Jaroongjittanusonti K, Polyiam K, Pomchaiya J, Siangloet W. Oral ivermectin versus 0.5% topical malathion lotion in patients with head lice: a systematic review. The Clinical Academia 2019;43(1):1-12.
Villegas SC, Breitzka RL. Head Lice and the Use of Spinosad. Clinical Therapeutics 2012/01/01/ 2012;34(1):14-23. doi: 10.1016/j.clinthera.2011.11.026
Pariser DM, Meinking TL, Bell M, Ryan WG. Topical 0.5% Ivermectin Lotion for Treatment of Head Lice. New England Journal of Medicine 2012;367(18):1687-1693. doi: 10.1056/NEJMoa1200107
Martínez de Murguía Fernández L, Puig Algora G, Bajona Roig M, Bacchini G. Effectiveness and tolerability of a squalane and dimethicone-based treatment for head lice. Parasitology Research 2021;120(5):1883-1890. doi: 10.1007/s00436-021-07113-y
Yamaguchi S, Yasumura R, Okamoto Y, et al. Efficacy and safety of a dimethicone lotion in patients with pyrethroid-resistant head lice in an epidemic area, Okinawa, Japan. The Journal of Dermatology 2021;48(9):1343-1349. doi: 10.1111/1346-8138.15966
Sittichok S, Wongnet O, Soonwera M. New Thai herbal shampoos as pediculicides for killing head louse, Pediculus humanus capitis De Geer (Phthiraptera). Asian Pacific Journal of Tropical Biomedicine 2018;8(2):106-112. doi: 10.4103/2221-1691.225614
Heukelbach J, Canyon D, Speare R. The effect of natural products on head lice: In vitro tests and clinical evidence. J Pediatr Infect Dis 2007;02(02):067-076. doi: 10.1055/s-0035-1557021
Soonwera M. Efficacy of herbal shampoo base on native plant against head lice (Pediculus humanus capitis De Geer, Pediculidae: Phthiraptera) in vitro and in vivo in Thailand. Parasitology Research 2014;113(9):3241-3250. doi: 10.1007/s00436-014-3986-6
Grieve K, Altman P, Rowe S, Staton J, Oppenheim V. A randomised, double-blind, comparative efficacy trial of three head lice treatment options: malathion, pyrethrins with piperonyl butoxide and MOOV Head Lice Solution. Aust Pharmacist 2007;26(9):738-743.
Sadhasivamohan A, Karthikeyan K, Palaniappan V. Pediculosis Capitis with Id Reaction and Plica Polonica. Am J Trop Med Hyg Jul 12 2021;105(4):862-863. doi: 10.4269/ajtmh.21-0271
Takkouche B, Norman G. PRISMA statement. Epidemiology 2011;22(1):128. doi: 10.1097/EDE.0b013e3181fe7999
Sterne JAC, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019;366:l4898. doi: 10.1136/bmj.l4898
Ghalandari N, Edalatkhah Tatafi A, Mohammadnezhad G, Nasimi M, Esmaily H. Comparing the efficacy of three methods of permethrin application in pediculosis capitis: A randomized clinical trial. Journal of Cosmetic Dermatology 2023;22(11):3065-3071. doi: 10.1111/jocd.15817
Kassiri H, Fahdani AE, Cheraghian B. Comparative efficacy of permethrin 1%, lindane 1%, and dimeticone 4% for the treatment of head louse infestation in Iran. Environ Sci Pollut Res Int Jan 2021;28(3):3506-3514. doi: 10.1007/s11356-020-10686-3
Hamedanian L, Nadoshan MRS, Vatandoost H, Baniardalani M, Rafinejad J. Evaluation of Efficiency of Ivermectin Lotion in Comparison with Permethrin Shampoo and Dimethicone Lotion for Treatment of Head Lice (Pediculus humanus capitis) in Areas Covered by Health Centers of Islamshahr City, Tehran, Iran in 2019. J Arthropod Borne Dis Sep 2021;15(3):325-332. doi: 10.18502/jad.v15i3.9820
Cardoso JHL, de Souza ANC, de Souza FM, Preire SS, Pincon C. Treatment of Head Louse Infestation with a Novel Mixture Made of Semi-Crystalline Polymers and Plant Extracts: Blind, Randomized, Controlled, Superiority Trial. Cosmetics Jun 2020;7(2)25. doi: 10.3390/cosmetics7020025
Burgess IF, Burgess NA. ''Anti-lice Protector Shampoo'': Clinical Study Shows Lack of Efficacy of Coconut Oil Derivatives in the Elimination of Head Louse Infestation. Turkiye Parazitol Derg Dec 2 2020;44(4):211-215. doi: 10.4274/tpd.galenos.2020.6361
Sungkar S, Dwinastiti YA, Haswinzky RA, et al. Effectiveness of wet combing compared with 1% permethrin lotion for the treatment of pediculosis capitis. Article. International Journal of Applied Pharmaceutics 2019;11(Special Issue 6):108-110. doi: 10.22159/ijap.2019.v11s6.33570
Kalari H, Soltani A, Azizi K, Faramarzi H, Moemenbellah-Fard MD. Comparative efficacy of three pediculicides to treat head lice infestation in primary school girls: a randomised controlled assessor blind trial in rural Iran. BMC Dermatol Sep 12 2019;19(1):13. doi: 10.1186/s12895-019-0093-5
Eertmans F, Rossel B, Serrano L, Rivera E, Adriaens E. Efficacy and Safety of a Water-Based Head Lice Lotion: A Randomized, Controlled, Investigator-Blinded, Comparative, Bicentric Study. Dermatol Ther (Heidelb) 2019;9(1):143-157. doi: 10.1007/s13555-018-0274-x
Bowles VM, Hanegraaf S, Ahveninen T, Sidgiddi S, Allenby K, Alsop H. Effect of a New Head Lice Treatment, Abametapir Lotion, 0.74%, on Louse Eggs: A Randomized, Double-Blind Study. Glob Pediatr Health 2019;6:2333794x19831295. doi: 10.1177/2333794X19831295
Greive KA, Barnes TM. The efficacy of Australian essential oils for the treatment of head lice infestation in children: A randomised controlled trial. Australas J Dermatol May 2018;59(2):e99-e105. doi: 10.1111/ajd.12626
Bowles VM, VanLuvanee LJ, Alsop H, et al. Clinical studies evaluating abametapir lotion, 0.74%, for the treatment of head louse infestation. Pediatr Dermatol Sep 2018;35(5):616-621. doi: 10.1111/pde.13612
Semmler M, Abdel-Ghaffar F, Gestmann F, et al. Randomized, investigator-blinded, controlled clinical study with lice shampoo (Licener (R)) versus dimethicone (Jacutin (R) Pedicul Fluid) for the treatment of infestations with head lice. Parasitology Research Jul 2017;116(7):1863-1870. doi: 10.1007/s00436-017-5461-7
Ghavami MB, Ahmadi S. Effectiveness of eucalyptus and cinnamon essential oils compared to permethrin in treatment of head lice infestation. Article. Journal of Zanjan University of Medical Sciences and Health Services 2017;25(112):86-98.
Wolf L, Eertmans F, Wolf D, Rossel B, Adriaens E. Efficacy and Safety of a Mineral Oil-Based Head Lice Shampoo: A Randomized, Controlled, Investigator-Blinded, Comparative Study. PLoS One 2016;11(6):e0156853. doi: 10.1371/journal.pone.0156853
Moemenbellah-Fard M, Nasiri Z, Azizi K, Fakoorziba M. Head lice treatment with two interventions: Pediculosis capitis profile in female schoolchildren of a rural setting in the south of Iran. Article. Annals of Tropical Medicine and Public Health 2016;9(4):245-250. doi: 10.4103/1755-6783.184790
Leulmi H, Diatta G, Sokhna C, Rolain JM, Raoult D. Assessment of oral ivermectin versus shampoo in the treatment of pediculosis (head lice infestation) in rural areas of Sine-Saloum, Senegal. Int J Antimicrob Agents Dec 2016;48(6):627-632. doi: 10.1016/j.ijantimicag.2016.07.014
Burgess IF, Brown CM, Nair P. Comparison of phenothrin mousse, phenothrin lotion, and wet-combing for treatment of head louse infestation in the UK: a pragmatic randomised, controlled, assessor blind trial. F1000Res 2014;3:158. doi: 10.12688/f1000research.2026.1
Meinking TL, Mertz-Rivera K, Villar ME, Bell M. Assessment of the safety and efficacy of three concentrations of topical ivermectin lotion as a treatment for head lice infestation. Int J Dermatol Jan 2013;52(1):106-12. doi: 10.1111/j.1365-4632.2012.05629.x
Burgess IF, Burgess NA, Brunton ER. Tocopheryl acetate 20% spray for elimination of head louse infestation: a randomised controlled trial comparing with 1% permethrin creme rinse. BMC Pharmacol Toxicol Sep 3 2013;14:43. doi: 10.1186/2050-6511-14-43
Burgess IF, Brunton ER, Burgess NA. Single application of 4% dimeticone liquid gel versus two applications of 1% permethrin creme rinse for treatment of head louse infestation: a randomised controlled trial. BMC Dermatol Apr 1 2013;13:5. doi: 10.1186/1471-5945-13-5
Komoda M, Yamaguchi S, Takahashi K, et al. Efficacy and safety of a combination regimen of phenothrin and ivermectin lotion in patients with head lice in Okinawa, Japan. The Journal of Dermatology 2020;47(7):720-727. doi: 10.1111/1346-8138.15348
Stough D, Shellabarger S, Quiring J, Gabrielsen AA, Jr. Efficacy and Safety of Spinosad and Permethrin Creme Rinses for Pediculosis Capitis (Head Lice). Pediatrics 2009;124(3):e389-e395. doi: 10.1542/peds.2008-3762
Taplin D, Meinking TL, Castiliero PM, Sanchez R. Permethrin 1% Creme Rinse for the Treatment of Pediculus humanus var capitis Infestation. Pediatric Dermatology 1986;3(4):344-348. doi: 10.1111/j.1525-1470.1986.tb00538.x
Soleimani-Ahmadi M, Jaberhashemi SA, Zare M, Sanei-Dehkordi A. Prevalence of head lice infestation and pediculicidal effect of permethrine shampoo in primary school girls in a low-income area in southeast of Iran. BMC Dermatology 2017/07/24 2017;17(1):10. doi: 10.1186/s12895-017-0062-9
Shahraki GH, Fararooie M, Karimi A. Controlling head lice in Iranian primary schools for girls. Asian Biomed 2013;7(2):281-285.
Pollack RJ, Kiszewski A, Armstrong P, et al. Differential Permethrin Susceptibility of Head Lice Sampled in the United States and Borneo. Archives of Pediatrics & Adolescent Medicine 1999;153(9):969-973. doi: 10.1001/archpedi.153.9.969
Lee SH, Yoon K-S, Williamson MS, et al. Molecular Analysis of kdr-like Resistance in Permethrin-Resistant Strains of Head Lice, Pediculus capitis. Pesticide Biochemistry and Physiology 2000/02/01/ 2000;66(2):130-143. doi: 10.1006/pest.1999.2460
Meinking TL, Serrano L, Hard B, et al. Comparative In Vitro Pediculicidal Efficacy of Treatments in a Resistant Head Lice Population in the United States. Archives of Dermatology 2002;138(2):220-224. doi: 10.1001/archderm.138.2.220
Husni L, Al-Waiz M. Topical ivermectin in the treatment of pediculosis capitis. Our Dermatology Online/Nasza Dermatologia Online 2021;12(1) doi: 10.7241/ourd.20211.3
Nofal A. Oral ivermectin for head lice: a comparison with 0.5 % topical malathion lotion. JDDG: Journal der Deutschen Dermatologischen Gesellschaft 2010;8(12):985-988. doi: 10.1111/j.1610-0387.2010.07487.x
Currie MJ, Reynolds GJ, Glasgow NJ, Bowden FJ. A pilot study of the use of oral ivermectin to treat head lice in primary school students in Australia. Pediatr Dermatol Nov-Dec 2010;27(6):595-9. doi: 10.1111/j.1525-1470.2010.01317.x
Chosidow O, Giraudeau B, Cottrell J, et al. Oral ivermectin versus malathion lotion for difficult-to-treat head lice. N Engl J Med 2010;362(10):896-905. doi: 10.1056/NEJMoa0905471
Pilger D, Heukelbach J, Khakban A, Oliveira FA, Fengler G, Feldmeier H. Household-wide ivermectin treatment for head lice in an impoverished community: randomized observer-blinded controlled trial. Bull World Health Organ Feb 2010;88(2):90-6. doi: 10.2471/BLT.08.051656
Davari B, Barik-Abi S, Nasirian H, Zahirnia AH, Mohammadi Y, Salehzadeh A. Comparative efficacy of topical dimethicone and permethrin for the treatment of head lice infestation in students. Chulalongkorn Medical Journal 2024;67(3):1. doi: 10.56808/2673-060X.5086
Burgess IF, Brown CM, Lee PN. Treatment of head louse infestation with 4% dimeticone lotion: randomised controlled equivalence trial. BMJ 2005;330(7505):1423. doi: 10.1136/bmj.38497.506481.8F
Woods AD, Porter CL, Feldman SR. Abametapir for the Treatment of Head Lice: A Drug Review. Annals of Pharmacotherapy 2022;56(3):352-357. doi: 10.1177/10600280211027968
Published
Issue
Section
License
The Copyright Form should be downloaded and signed by corresponding author in the fourth step "upload supplementary files" during submission process.
After acceptance, copyright form should be downloaded and signed by all authors one by one ( "summery --> supp. file" part and click on "add a supplementary file" link).
https://orcid.org/0000-0003-4407-6114

