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Treatment of Pediculosis Capitis: A Critical Appraisal of the Current Literature


Pediculosis capitis is the most common ectoparasitic disease in children in industrialized countries and extremely common in resource-poor communities of the developing world. The extensive use of pediculicides with a neurotoxic mode of action has led to the development and spread of resistant head lice populations all over the world. This triggered the development of compounds with other modes of action. The current literature on treatment approaches of head lice infestation was searched, and published randomized controlled trials were critically analyzed. The following compounds/family of compounds were identified: spinosad, a novel compound with a new neurotoxic mode of action, isopropyl myristate, 1,2-octanediol, ivermectin, plant-based products, and dimeticones. The efficacy and safety of these compounds are reviewed and recommendations for the treatment of pediculosis capitis in individuals as well as the interruption of ongoing epidemics are provided.

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The excellent secretarial assistance by U. Kolander is gratefully acknowledged.

Conflict of interest

Dr. Feldmeier reports receiving consulting and lecture fees from Pohl-Boskamp. No other potential conflict of interest relevant to this article is reported.

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Correspondence to Hermann Feldmeier.

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Feldmeier, H. Treatment of Pediculosis Capitis: A Critical Appraisal of the Current Literature. Am J Clin Dermatol 15, 401–412 (2014).

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  • Ivermectin
  • Spinosad
  • Head Louse
  • Ovicidal Activity
  • Isopropyl Myristate