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BMC Dermatology

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Open Access 01-12-2013 | 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

Authors: Ian F Burgess, Elizabeth R Brunton, Nazma A Burgess

Published in: BMC Dermatology | Issue 1/2013

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 The low efficacy of permethrin suggests it should be withdrawn.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.

Available only for authorised users

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Burgess IF, Brown CM, Lee PN: Treatment of head louse infestation with 4% dimeticone lotion: randomised controlled equivalence trial. BMJ 2005, 330: 1423–1425. 10.1136/bmj.38497.506481.8FCrossRefPubMedPubMedCentral

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Kurt O, Balcioglu IC, Burgess IF, Limoncu ME, Girginkardesler N, Tabak T, Muslu H, Ermis O, Sahin MT, Bilac C, Kavur H, Ozbel Y: Treatment of head lice with dimeticone 4% lotion: comparison of two formulations in a randomised controlled trial in rural Turkey. BMC Public Health 2009, 9: 441. 10.1186/1471-2458-9-441CrossRefPubMedPubMedCentral

Burgess IF, Burgess NA: Dimeticone 4% liquid gel found to kill all lice and eggs with a single 15 minute application. BMC Res Notes 2011, 4: 15. 10.1186/1756-0500-4-15CrossRefPubMedPubMedCentral

Burgess IF: The mode of action of dimeticone 4% lotion against head lice. Pediculus capitis. BMC Pharmacol 2009, 9: 3.CrossRefPubMedPubMedCentral

Barker SC, Burgess I, Meinking TL, Mumcuoglu KY: International guidelines for clinical trials with pediculicides. Int J Dermatol 2012, 51: 853–858. 10.1111/j.1365-4632.2011.05446.xCrossRefPubMed

Meinking TL, Clineschmidt CM, Chen C, Kolber MA, Tipping RW, Furtek CI, Villar ME, Guzzo CA: An observer-blinded study of 1% permethrin crème rinse with and without adjunctive combing in patients with head lice. J Pediatr 2002, 141: 665–670. 10.1067/mpd.2002.129031CrossRefPubMed

Burgess IF, Lee PN, Brown CM: Randomised, controlled, parallel group clinical trials to evaluate the efficacy of isopropyl myristate/cyclomethicone solution against head lice. Pharm J 2008, 280: 371–375.

10.

Burgess IF, Brunton ER, Burgess NA: Clinical trial showing superiority of a coconut and anise spray over permethrin 0.43% lotion for head louse infestation, ISRCTN9646978. Eur J Pediatr 2010, 169: 55–62. 10.1007/s00431-009-0978-0CrossRefPubMed

11.

Burgess IF, Burgess NA, Brunton ER: Soya oil based shampoo superior to 0.5% permethrin lotion against head louse infestation: randomized clinical trial. Med Devices (Auckl) 2011, 4: 35–42.CrossRef

12.

Burgess IF, Lee PN, Kay K, Jones R, Brunton ER: 1,2-octanediol, a novel surfactant, for treating head louse infestation: identification of activity, formulation, and randomised, controlled trials. PLoS ONE 2012,7(4):e35419. 10.1371/journal.pone.0035419CrossRefPubMedPubMedCentral

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-5945/13/5/prepub

Title: 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
Authors: Ian F Burgess
Elizabeth R Brunton
Nazma A Burgess
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: BMC Dermatology / Issue 1/2013
Electronic ISSN: 1471-5945
DOI: https://doi.org/10.1186/1471-5945-13-5

At a glance: The STEP trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

Trial registration

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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BMC Dermatology reviewer acknowledgement, 2012