The aim of this review was to assess the effects of interventions for head lice. Randomised trials (published and unpublished) or trials using alternate allocation were sought which compared pediculicides with the same and different formulations of other pediculicides, and pediculicides with physical methods. Of the 71 identified studies, only four met the inclusion criteria. Two reviewers independently assessed trial quality. One reviewer extracted the data. No evidence was found that any one pediculicide has greater effect than another. The two studies comparing malathion and permethrin with their respective vehicles showed a higher cure rate for the active ingredient than the vehicle. Another study comparing synergised pyrethrins with permethrin showed their effects to be equivalent. A comparative trial of malathion lotion vs combing, showed combing to be ineffective for the cureative treatment of head lice infection. Adverse effects were reported in a number of trials and were all minor, although reporting quality varied between trials. It is concluded that permethrin, synergised pyrethrin and malathion were effective in the treatment of head lice. However, the emergence of drug resistance since these trials were conducted means there is no direct contemporary evidence of the comparative effectiveness of these products. The 'best' choice will now depend on local resistance patterns. Physical treatment methods(BugBusting) were shown to be ineffective in treating head lice. No evidence exists regarding other chemical control methods such as the use of herbal treatments, when used in the curative treatment of head lice. Future trials should take into account the methodological recommendations that arise from this review.
Update: The Editor withdrew this review as of Issue 4, 2006. This review will be reinstated following a substantive update.
The Cochrane Database of Systematic Reviews 2001, Issue 2. Art. No.: CD001165. DOI: 10.1002/14651858.CD001165.