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Open Access Research article

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

Ian F Burgess*, Elizabeth R Brunton and Nazma A Burgess

Author Affiliations

Medical Entomology Centre, Insect Research & Development Limited, 6 Quy Court, Colliers Lane, Stow-cum-Quy, Cambridge CB25 9AU, UK

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BMC Dermatology 2013, 13:5  doi:10.1186/1471-5945-13-5

Published: 1 April 2013

Abstract

Background

A previous study indicated that a single application of 4% dimeticone liquid gel was effective in treating head louse infestation. This study was designed to confirm this in comparison with two applications of 1% permethrin.

Methods

We have performed a single centre parallel group, randomised, controlled, open label, community based trial, with domiciliary visits, in Cambridgeshire, UK. Treatments were allocated through sealed instructions derived from a computer generated list. We enrolled 90 children and adults with confirmed head louse infestation analysed by intention to treat (80 per-protocol after 4 drop outs and 6 non-compliant). The comparison was between 4% dimeticone liquid gel applied once for 15 minutes and 1% permethrin creme rinse applied for 10 minutes, repeated after 7 days as per manufacturer’s directions. Evaluated by elimination of louse infestation after completion of treatment application regimen.

Results

Intention to treat comparison of a single dimeticone liquid gel treatment with two of permethrin gave success for 30/43 (69.8%) of the dimeticone liquid gel group and 7/47 (14.9%) of the permethrin creme rinse group (OR 13.19, 95% CI 4.69 to 37.07) (p < 0.001). Per protocol results were similar with 27/35 (77.1%) success for dimeticone versus 7/45 (15.6%) for permethrin. Analyses by household gave essentially similar outcomes.

Conclusions

The study showed one 15 minute application of 4% dimeticone liquid gel was superior to two applications of 1% permethrin creme rinse (p < 0.001). The low efficacy of permethrin suggests it should be withdrawn.

Trial registration

Current Controlled Trials ISRCTN88144046.

Keywords:
Dimeticone; Head lice; Insecticides; Pediculosis; Permethrin; Physical mode of action; Treatment regimen