brand logo

Am Fam Physician. 2005;71(11):2183-2184

Head lice are becoming increasingly resistant to conventional treatment (i.e., neurotoxic insecticides, household cleaning, and nit removal). Pearlman studied the efficacy of a dry-on, suffocation-based pediculicide (DSP) treatment, which is applied wet and blown dry-on the hair, enveloping the insect in a “shrink-wrapped” film.

The study involved two uncontrolled open trials. Inclusion criteria were active difficult-to-treat head lice infestation and failure to respond to or parental refusal to use conventional neurotoxins. Patients in both trials were provided with clean combs, brushes, clothing, and bedding, and were given a weekly DSP treatment until cured, or up to three applications. The nits were removed after DSP application using a nit comb in the first trial, but not in the second trial. Patients were considered cured if they experienced no increased scratching and itching, and there were no visible lice or nits after a wet combing test.

Of the 133 participants who completed the study, 120 were reevaluated after six months. One half of the patients were unresponsive to standard treatments before participating in the study. Trials 1 and 2 had similar cure rates (97 versus 95 percent) and long-term remission rates (94 versus 95 percent). Compared with patients in the second trial, those in the first trial had at least 100 times more nits removed during combing.

The author concludes that the rate of cure with DSP was high, and the rate of reinfestation after six months was low. Patients who did not respond after three applications were cured after a fourth application. Nit removal was not necessary in effecting cure.

Continue Reading

More in AFP

Copyright © 2005 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See permissions for copyright questions and/or permission requests.