Letters

Clinical efficacy of treatment for head lice

EDITOR,--In their review of drug treatments for head lice Robert H Vander Stichele and colleagues identified only seven clinical trials in the past 29 years that met their evaluation criteria.¹ However, visual inspection (their main measure for clinical evaluation) is flawed.² Furthermore, to determine ovicidity a comparison of the hatching rate of treated and untreated eggs after incubation, to simulate the conditions on the head, is necessary.³

Use of a hand lens to detect hatchlings on the head is impractical because lice move rapidly away from disturbance in dry hair. Mathias et al found the application of isopropanol alcohol to be helpful as it causes lice to fall from the head.⁴ Other workers use a fine toothed comb to detect lice. Nevertheless, none of these methods is sufficiently controlled to replace incubation in the assessment of ovicidity.

Vander Stichele et al . . . [Full text of this article]

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Relevant Article

Systematic review of clinical efficacy of topical treatments for head lice

Robert H Vander Stichele, Els M Dezeure, and Marc G Bogaert
BMJ 1995 311: 604-608. [Abstract] [Full Text]

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• Pearlman, D. L. (2004). A Simple Treatment for Head Lice: Dry-On, Suffocation-Based Pediculicide. Pediatrics 114: e275-e279 [Abstract] [Full text]  
• Roberts, R. J. (2002). Head Lice. NEJM 346: 1645-1650 [Full text]  
• Hipolito, R. B., Mallorca, F. G., Zuniga-Macaraig, Z. O., Apolinario, P. C., Wheeler-Sherman, J. (2001). Head Lice Infestation: Single Drug Versus Combination Therapy With One Percent Permethrin and Trimethoprim/Sulfamethoxazole. Pediatrics 107: 30e-30 [Abstract] [Full text]