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Pediculosis capitis: new insights into epidemiology, diagnosis and treatment

  • H. Feldmeier
Review

Abstract

Pediculosis capitis is a ubiquitous parasitic skin disease caused by Pediculus humanus capitis. Head lice are highly specialised parasites which can propagate only on human scalp and hair. Transmission occurs by direct head-to-head contact. Head lice are vectors of important bacterial pathogens. Pediculosis capitis usually occurs in small epidemics in play groups, kindergartens and schools. Population-based studies in European countries show highly diverging prevalences, ranging from 1% to 20%. The diagnosis of head lice infestation is made through the visual inspection of hair and scalp or dry/wet combing. The optimal method for the diagnosis of active head lice infestation is dry/wet combing. Topical application of a pediculicide is the most common treatment. Compounds with a neurotoxic mode of action are widely used but are becoming less effective due to resistant parasite populations. Besides, their use is restricted by safety concerns. Dimeticones, silicone oils with a low surface tension and the propensity to perfectly coat surfaces, have a purely physical mode of action. This group of compounds is highly effective and safe, and there is no risk that head lice become resistant. The control of epidemics requires active contact tracing and synchronised treatment with an effective and safe pediculicide.

Keywords

Ivermectin Head Louse Pyrethrin Isopropyl Myristate Piperonyl Butoxide 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Jahnke C, Bauer E, Feldmeier H (2008) Pediculosis capitis im kindesalter: epidemiologische und sozialmedizinische erkenntnisse einer reihenuntersuchung von schulanfängern. Gesundheitswesen 70:667–673PubMedCrossRefGoogle Scholar
  2. 2.
    Rukke BA, Birkemoe T, Soleng A, Lindstedt HH, Ottesen P (2011) Head lice prevalence among households in Norway: importance of spatial variables and individual and household characteristics. Parasitology 138:1296–1304PubMedCrossRefGoogle Scholar
  3. 3.
    Falagas ME, Matthaiou DK, Rafailidis PI, Panos G, Pappas G (2008) Worldwide prevalence of head lice. Emerg Infect Dis 14:1493–1494PubMedCrossRefGoogle Scholar
  4. 4.
    Vassena CV, Mougabure Cueto G, González Audino P, Alzogaray RA, Zerba EN, Picollo MI (2003) Prevalence and levels of permethrin resistance in Pediculus humanus capitis de geer (Anoplura: Pediculidae) from Buenos Aires, Argentina. J Med Entomol 40:447–450PubMedCrossRefGoogle Scholar
  5. 5.
    Kasai S, Ishii N, Natsuaki M, Fukutomi H, Komagata O, Kobayashi M, Tomita T (2009) Prevalence of kdr-like mutations associated with pyrethroid resistance in human head louse populations in Japan. J Med Entomol 46:77–82PubMedCrossRefGoogle Scholar
  6. 6.
    Durand R, Millard B, Bouges-Michel C, Bruel C, Bouvresse S, Izri A (2007) Detection of pyrethroid resistance gene in head lice in schoolchildren from Bobigny, France. J Med Entomol 44:796–798PubMedCrossRefGoogle Scholar
  7. 7.
    Kristensen M, Knorr M, Rasmussen AM, Jespersen JB (2006) Survey of permethrin and malathion resistance in human head lice populations from Denmark. J Med Entomol 43:533–538PubMedCrossRefGoogle Scholar
  8. 8.
    Yoon KS, Gao JR, Lee SH, Clark JM, Brown L, Taplin D (2003) Permethrin-resistant human head lice, Pediculus capitis, and their treatment. Arch Dermatol 139:994–1000PubMedCrossRefGoogle Scholar
  9. 9.
    Weiss RA (2009) Apes, lice and prehistory. J Biol 8:20. doi: 10.1186/jbiol114 PubMedCrossRefGoogle Scholar
  10. 10.
    Reed DL, Light JE, Allen JM, Kirchman JJ (2007) Pair of lice lost or parasites regained: the evolutionary history of anthropoid primate lice. BMC Biol 5:7. doi: 10.1186/1741-7007-5-7 PubMedCrossRefGoogle Scholar
  11. 11.
    Light JE, Allen JM, Long LM, Carter TE, Barrow L, Suren G, Raoult D, Reed DL (2008) Geographic distributions and origins of human head lice (Pediculus humanus capitis) based on mitochondrial data. J Parasitol 94:1275–1281PubMedCrossRefGoogle Scholar
  12. 12.
    Parola P, Fournier PE, Raoult D (2006) Bartonella quintana, lice, and molecular tools. J Med Entomol 43:787PubMedCrossRefGoogle Scholar
  13. 13.
    Reed DL, Smith VS, Hammond SL, Rogers AR, Clayton DH (2004) Genetic analysis of lice supports direct contact between modern and archaic humans. PLoS Biol 2:e340PubMedCrossRefGoogle Scholar
  14. 14.
    Feldmeier H (2010) Lice as vectors of pathogenic microorganisms. In: Heukelbach J (ed) Management and control of head lice infestations. UNI-MED Verlag, Bremen, pp 132–135Google Scholar
  15. 15.
    Angelakis E, Diatta G, Abdissa A, Trape JF, Mediannikov O, Richet H, Raoult D (2011) Altitude-dependent Bartonella quintana genotype C in head lice, Ethiopia. Emerg Infect Dis 17:2357–2359PubMedCrossRefGoogle Scholar
  16. 16.
    Mumcuoglu KY, Miller J, Manor O, Ben-Yshai F, Klaus S (1993) The prevalence of ectoparasites in Ethiopian immigrants. Isr J Med Sci 29:371–373PubMedGoogle Scholar
  17. 17.
    Feldmeier H (2006) Pediculosis capitis: die wichtigste parasitose des kindesalters. Kinder- und Jugendmedizin 4:249–259Google Scholar
  18. 18.
    Willems S, Lapeere H, Haedens N, Pasteels I, Naeyaert JM, De Maeseneer J (2005) The importance of socio-economic status and individual characteristics on the prevalence of head lice in schoolchildren. Eur J Dermatol 15:387–392PubMedGoogle Scholar
  19. 19.
    Buczek A, Markowska-Gosik D, Widomska D, Kawa IM (2004) Pediculosis capitis among schoolchildren in urban and rural areas of eastern Poland. Eur J of Epidemiol 19:491–495CrossRefGoogle Scholar
  20. 20.
    Courtiade C, Labrèze C, Fontan I, Taïeb A, Maleville J (1993) La pédiculose du cuir chevelu: enquete par questionnaire dans quatre groupes scolaires de l’académie de Bordeaux. Ann Dermatol Venereol 120:363–368PubMedGoogle Scholar
  21. 21.
    Kokturk A, Baz K, Bugdayci R, Sasmaz T, Tursen U, Kaya TI, Ikizoglu G (2003) The prevalence of pediculosis capitis in schoolchildren in Mersin, Turkey. Int J Dermatol 42:694–698PubMedCrossRefGoogle Scholar
  22. 22.
    Downs AMR, Stafford KA, Coles GC (1999) Head lice: prevalence in schoolchildren and insecticide resistance. Parasitol Today 15:1–4PubMedCrossRefGoogle Scholar
  23. 23.
    Jahnke C, Bauer E, Hengge UR, Feldmeier H (2009) Accuracy of diagnosis of pediculosis capitis: visual inspection vs wet combing. Arch Dermatol 145:309–313PubMedCrossRefGoogle Scholar
  24. 24.
    Bauer E, Jahnke C, Feldmeier H (2009) Seasonal fluctuations of head lice infestation in Germany. Parasitol Res 104:677–681PubMedCrossRefGoogle Scholar
  25. 25.
    Canyon DV, Speare R (2010) Indirect transmission of head lice via inanimate objects. Open Dermatol J 4:72–76CrossRefGoogle Scholar
  26. 26.
    Feldmeier H (2010) Diagnosis of head lice infestations: an evidence-based review. Open Dermatol J 4:69–71CrossRefGoogle Scholar
  27. 27.
    Nash B (2003) Treating head lice. BMJ 326:1256–1257PubMedCrossRefGoogle Scholar
  28. 28.
    De Maeseneer J, Blokland I, Willems S, Vander Stichele RH, Meersschaut F (2000) Wet combing versus traditional scalp inspection to detect head lice in schoolchildren: observational study. BMJ 32:1187–1188CrossRefGoogle Scholar
  29. 29.
    Mumcuoglu KY, Friger M, Ioffe-Uspensky I, Ben-Ishai F, Miller J (2001) Louse comb versus direct visual examination for the diagnosis of head louse infestations. Pediatr Dermatol 18:9–12PubMedCrossRefGoogle Scholar
  30. 30.
    Pollack RJ, Kiszewski AE, Spielman A (2000) Overdiagnosis and consequent mismanagement of head louse infestations in North America. Pediatr Infect Dis J 19:689–693PubMedCrossRefGoogle Scholar
  31. 31.
    Sonnberg S, Oliveira FA, de Melo ILA, de Melo Soares MM, Becher H, Heukelbach J (2010) Ex vivo development of eggs from head lice (Pediculus humanus capitis). Open Dermatol J 4:82–89CrossRefGoogle Scholar
  32. 32.
    Chosidow O, Giraudeau B, Cottrell J, Izri A, Hofmann R, Mann SG, Burgess I (2010) Oral ivermectin versus malathion lotion for difficult-to-treat head lice. N Engl J Med 362:896–905PubMedCrossRefGoogle Scholar
  33. 33.
    Munirathinam A, Sunish IP, Rajendran R, Tyagi BK (2009) Impact of ivermectin drug combinations on Pediculus humanus capitis infestation in primary schoolchildren of south Indian rural villages. Int J Dermatol 48:1201–1205PubMedCrossRefGoogle Scholar
  34. 34.
    Elston DM (2003) Drug-resistant lice. Arch Dermatol 139:1061–1064PubMedCrossRefGoogle Scholar
  35. 35.
    Picollo MI, Vassena CV, Mougabure Cueto GA, Vernetti M, Zerba EN (2000) Resistance to insecticides and effect of synergists on permethrin toxicity in Pediculus capitis (Anoplura: Pediculidae) from Buenos Aires. J Med Entomol 37:721–725PubMedCrossRefGoogle Scholar
  36. 36.
    Bailey AM, Prociv P (2000) Persistent head lice following multiple treatments: evidence for insecticide resistance in Pediculus humanus capitis. Australas J Dermatol 41:250–254PubMedCrossRefGoogle Scholar
  37. 37.
    Hunter JA, Barker SC (2003) Susceptibility of head lice (Pediculus humanus capitis) to pediculicides in Australia. Parasitol Res 90:476–478PubMedCrossRefGoogle Scholar
  38. 38.
    Burgess IF, Kay K, Burgess NA, Brunton ER (2011) Soya oil-based shampoo superior to 0.5% permethrin lotion for head louse infestation. Med Devices Evidence Res 4:35–42CrossRefGoogle Scholar
  39. 39.
    Burgess IF, Lee PN, Brown CM (2008) Randomised, controlled, parallel group clinical trials to evaluate the efficacy of isopropyl myristate/cyclomethicone solution against head lice. Pharmaceut J 280:371–375Google Scholar
  40. 40.
    Burgess IF, Brunton ER, Burgess NA (2010) Clinical trial showing superiority of a coconut and anise spray over permethrin 0.43% lotion for head louse infestation, ISRCTN96469780. Eur J Pediatr 169:55–62PubMedCrossRefGoogle Scholar
  41. 41.
    Tomalik-Scharte D, Lazar A, Meins J, Bastian B, Ihrig M, Wachall B, Jetter A, Tantcheva-Poór I, Mahrle G, Fuhr U (2005) Dermal absorption of permethrin following topical administration. Eur J Clin Pharmacol 61:399–404PubMedCrossRefGoogle Scholar
  42. 42.
    Feldmeier H, Jahnke C (2010) Pediculosis capitis. Epidemiologie, Diagnose und Therapie. Pädiatrische Praxis 76:359–370Google Scholar
  43. 43.
    [No authors listed] (2009) Topische Therapie bei Kopfläusen. Der Arzneimttelbrief 43:81–86 Google Scholar
  44. 44.
    Menegaux F, Baruchel A, Bertrand Y, Lescoeur B, Leverger G, Nelken B, Sommelet D, Hémon D, Clavel J (2006) Household exposure to pesticides and risk of childhood acute leukaemia. Occup Environ Med 63:131–134PubMedCrossRefGoogle Scholar
  45. 45.
    Yang YC, Lee HS, Clark JM, Ahn YJ (2004) Insecticidal activity of plant essential oils against Pediculus humanus capitis (Anoplura: Pediculidae). J Med Entomol 41:699–704PubMedCrossRefGoogle Scholar
  46. 46.
    Gonzalez Audino P, Vassena C, Zerba E, Picollo M (2007) Effectiveness of lotions based on essential oils from aromatic plants against permethrin resistant Pediculus humanus capitis. Arch Dermatol Res 299:389–392PubMedCrossRefGoogle Scholar
  47. 47.
    Heukelbach J, Canyon DV, Speare R (2007) The effect of natural products on head lice: in vitro tests and clinical evidence. J Ped Infect Dis 2:67–76Google Scholar
  48. 48.
    Burgess IF (2009) The mode of action of dimeticone 4% lotion against head lice, Pediculus capitis. BMC Pharmacol 9:3. doi: 10.1186/1471-2210-9-3 PubMedCrossRefGoogle Scholar
  49. 49.
    Richling I, Böckeler W (2008) Lethal effects of treatment with a special dimeticone formula on head lice and house crickets (Orthoptera, Ensifera: Acheta domestica and Anoplura, phthiraptera: Pediculus humanus). Insights into physical mechanisms. Arzneimittelforschung 58:248–254PubMedGoogle Scholar
  50. 50.
    Heuckelbach J, Oliveira FA, Richter J, Häussinger D (2010) Dimeticone-based pediculicides: a physical approach to eradicate head lice. Open Dermatol J 4:77–81CrossRefGoogle Scholar
  51. 51.
    Nair B; Cosmetic Ingredients Review Expert Panel (2003) Final report on the safety assessment of stearoxy dimethicone, dimethicone, methicone, amino bispropyl dimethicone, aminopropyl dimethicone, amodimethicone, amodimethicone hydroxystearate, behenoxy dimethicone, C24-28 alkyl methicone, C30-45 alkyl methicone, C30-45 alkyl dimethicone, cetearyl methicone, cetyl dimethicone, dimethoxysilyl ethylenediaminopropyl dimethicone, hexyl methicone, hydroxypropyldimethicone, stearamidopropyl dimethicone, stearyl dimethicone, stearyl methicone, and vinyldimethicone. Int J Toxicol 22:11–35PubMedGoogle Scholar
  52. 52.
    Kurt O, Balcioğlu IC, Burgess IF, Limoncu ME, Girginkardeşler N, Tabak T, Muslu H, Ermiş O, Sahin MT, Bilac C, Kavur H, Ozbel Y (2009) Treatment of head lice with dimeticone 4% lotion: comparison of two formulations in a randomised controlled trial in rural Turkey. BMC Public Health 9:441PubMedCrossRefGoogle Scholar
  53. 53.
    Burgess IF, Lee PN, Matlock G (2007) Randomised, controlled, assessor blind trial comparing 4% dimeticone lotion with 0.5% malathion liquid for head louse infestation. PLoS One 2:e1127PubMedCrossRefGoogle Scholar
  54. 54.
    Burgess IF, Brown CM, Lee PN (2005) Treatment of head louse infestation with 4% dimeticone lotion: randomised controlled equivalence trial. BMJ 330:1423–1426PubMedCrossRefGoogle Scholar
  55. 55.
    Heukelbach J, Pilger D, Oliveira FA, Khakban A, Ariza L, Feldmeier H (2008) A highly efficacious pediculicide based on dimeticone: randomized observer blinded comparative trial. BMC Infect Dis 8:115. doi: 10.1186/1471-2334-8-115 PubMedCrossRefGoogle Scholar
  56. 56.
    Heukelbach J, Sonnberg S, Becher H, Melo I, Speare R, Oliveira FA (2011) Ovicidal efficacy of high concentration dimeticone: a new era of head lice treatment. J Am Acad Dermatol 64:e61–e62PubMedCrossRefGoogle Scholar
  57. 57.
    Laguna MF, Risau-Gusman S (2011) Of lice and math: using models to understand and control populations of head lice. PLoS One 6:e21848. doi: 10.1371/journal.pone.0021848 PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Institute of Microbiology and HygieneCharité University Medicine, Campus Benjamin FranklinBerlinGermany

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