Soya oil-based shampoo superior to 0.5% permethrin lotion for head louse infestation

Ian F Burgess¹, Katrina Kay^1,2, Nazma A Burgess¹, Elizabeth R Brunton^1
1Medical Entomology Centre, Insect Research and Development Limited, Cambridge, ²Leeds Primary Care Trust, Leeds, UK

Background: This was a randomized, assessor-blind, controlled comparison of a soya oil-based medical device shampoo with a medicinal permethrin lotion in an alcohol vehicle for treatment of head louse infestation to generate data suitable for a regulatory submission to achieve reimbursable status for the shampoo product.
Methods: We treated 91 children and adults, divided between two sites, on two occasions 9 days apart. Participants washed their hair and towel-dried it before treatment. The shampoo was used twice for 30 minutes each time. The lotion was used for 30 minutes followed by rinsing. Assessments were made by dry detection combing on days 2, 9, 11, and 14 after the first treatment. According to present knowledge, this combing technique does not influence the overall head louse populations or outcome of treatment.
Results: The soya oil shampoo was significantly (P < 0.01) more effective than the lotion for both intention to treat (62.2% versus 34.8% successful treatment) and per-protocol (74.3% versus 36.8% success) groups. Post-treatment assessments showed the necessity for repeat treatment, but that a 9-day interval was too long because if eggs hatched after the first treatment, the lice could grow old enough to lay eggs before the second treatment.
Conclusion: The soya oil-based shampoo was more effective than the permethrin lotion, more cosmetically acceptable, and less irritant.

Keywords: pediculosis, medical device, medicinal product, insecticide, vegetable oil

Corrigendum for this paper has been published