EFFECTIVENESS OF WET COMBING COMPARED WITH 1% PERMETHRIN LOTION FOR THE TREATMENT OF PEDICULOSIS CAPITIS
Objective: Pediculus humanus capitis is an ectoparasite that sucks blood from the patient’s scalp. Gamma-hexachlorocyclohexane is an effective treatment but its use has been discontinued because of its neurotoxicity. Although the replacement pediculicide is permethrin, this is not affordable for everyone, and thus the recommended treatment is wet combing. The aim of this study is to evaluate the effectiveness of permethrin compared with wet combing for eliminating pediculosis.
Methods: This study was a randomized controlled trial (RCT) conducted in a boarding school in Bogor District; the data were collected in July–August, 2018. Subjects were regarded as infested if lice were found during examination. Infested subjects were divided into two groups. In the permethrin group, the hair was wetted with permethrin lotion and left for 10 min. Afterwards, a fine-toothed comb was used to remove lice, and then the subjects were instructed to wash their hair with shampoo. On day 14, each subject’s head was reexamined to determine the cure rate. The wet-combing group was treated similarly but using conditioner instead of permethrin.
Results: Of 121 subjects, 88.4% were infested with head lice. The cure rate after one week of treatment was 66% in the permethrin group and 63% in the wet-combing group. After a two-week course of treatment, the cure rate increased to 94% in permethrin group and 89% in the wet-combing group. There was no significant difference in cure rate between permethrin and wet combing after a one-(P = 0.740) or two-week (P = 0.507) course of treatment.
Conclusion: The prevalence of pediculosis capitis in a boarding school in Bogor District was 88.4%. Wet combing treatment was as effective as permethrin for treating pediculosis capitis.
2. Abdolhosseini S, Mokaberinejad R, Alian Nezhadi V, Bozorgi M, Nazem E. Evaluation of treatment with squill vinegar in 10 patients with head pediculosis. Asian J Clin Case Rep Trad Alt Mod 2017;1:57–64.
3. Wolff K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ. Fitzpatrick’s dermatology in general medicine. 17th ed. New York: McGraw-Hill; 2008. p. 2029–37.
4. Cummings C, Finlay JC, MacDonald JE. Head lice infestations: a clinical update. Paediat Child Health 2018;23:18–24.
5. Sangare AK, Doumbo OK, Raoult D. Management and treatment of human lice. Biomed Res Int 2016. DOI:10.1155/2016/8962685
6. Schenone H, Wiedmaier G, Contreras L. Treatment of pediculosis capitis in children with permethrin 1% shampoo or lotion. Bull Chil Parasitol 1994;49:49-52.
7. Requirements and steps for pesticide submission. Decision of Agriculture Ministry Republic of Indonesia No: 434.1/KPTS/TP.270/7; 2001.
8. Hapsari YC. Treatment effectiveness comparison between wet combing and 0.5% hexachlorocyclohexane lotion on female students with pediculosis capitis in a boarding school in Jakarta. Jakarta [thesis]. Universitas Indonesia; 2013.
9. Tebruegge M, Runnacles J. Is wet combing effective in children with pediculosis capitis infestation? Arch Dis Child 2007;92:818–20.
10. Lacarruba F, Boscaglia S, Dinotta F, Micali G. Pediculosis. Atlas Pediatr Dermatoscopy 2018;9:63–70.
11. Pediculosis [Internet] Atlanta Centers for Disease Control and Prevention; 2017. Available from: https://www.cdc.gov/dpdx/pediculosis/index.html [Last accessed on 27 May 2018]
12. Bohl B, Evetts J, McClain K, Rosenauer A, Stellitano E. Clinical practice updates: pediculosis capitis. Pediatr Nurs 2015;41:227-34.
13. Verma P, Namdeo C. Treatment for pediculosis capitis. Indian J Dermatol 2015;60:238–47.
14. Glasziou P, Bennett J, Greenberg P, Green S, Gunn J, Huffman T. Wet combing for the eradication of head lice [Internet] Melbourne. Australian Family Physician; 2013. Available from https://www.racgp.org.au/afp/2013/march/wet-combing/ [Last accessed on 27 May 2018]
15. Tappeh KH, Chavsin AR, Hajipirloo HM, Khashaveh S, Hanifian H, Bozorgomid A, et al. Pediculosis capitis among primary school children and related risk factors in Urmia, the main city of West Azarbaijan, Iran. J Arthropod Borne Dis 2012;6:79–85.
16. Rassami W, Soonwera M. Epidemiology of pediculosis capitis among schoolchildren in the eastern area of Bangkok, Thailand. Asian Pac J Trop Biomed 2012;2:901–4.
17. Degeril S, Malatyali E, Mumcuoglu KY. Head lice prevalence and associated factors in two boarding schools in Sivas. Turkiye Parazitol Derg 2013;37:32–5.
18. Assaedi LA, Alharbi AH, Aldor SM, Albarakati BA, Alsahafi IK, Magliah RF, et al. The prevalence of pediculosis capitis in makkah city, Saudi Arabia. Our Dermatol Online 2018;9:114–7.
19. Manrique Saide P, Pavia Ruz N, Rodriguez Buenfil JC, Herrera R, Gomez Ruiz P, Pilger D. Prevalence of pediculosis capitis in children from a rural school in yucatan, mexico. Rev Inst Med Trop Sao Paulo 2011;53:325–7.
20. El-Sayed MM, Toama MA, Abdelshafy AS, Esawy AM, El-Naggar SA. Prevalence of pediculosis capitis among primary school students at Sharkia Governorate by using dermoscopy. Egypt J Dermatol Venerol 2017;37:33–42.
21. Leeshafft H, Baier A, Guerra H, Terashima A, Feldmeier H. Prevalence and risk factors associated with pediculosis capitis in an impoverished urban community in Lima, Peru. J Glob Infect Dis 2013;5:138–43.
22. 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 randomized, controlled, assessor blind trial. F1000 Res 2014;3:158.
23. Hill N, Moor G, Cameron MM, Butlin A, Preston S, Williamson MS, et al. Single blind, randomized, comparative study of the bug buster kit and over-the-counter pediculicide treatments against head lice in the United Kingdom. Br Med J 2005;331:384–7.
24. Dodd C. Treatment of head lice. Br Med J 2001;323:1084.
25. Meinking TL, Clineschimdt CM, Chen C, Kolber MA, Tipping RW, Furtek CI, et al. An observer-blinded study of 1% permethrine creme rinse with and without adjunctive combing in patients with head lice. J Pediatr 2002;141:665–70.
26. Lebwohl M, Clark L, Levitt J. Therapy of head lice based on life cycle, resistance, and safety considerations. Pediatrics 2007;119:965–7.
27. Devore CD, Schutze GE. Head lice. Pediatrics 2015;135:1355–8.
This work is licensed under a Creative Commons Attribution 4.0 International License.