HOW EFFECTIVE ARE HEAD LICE TREATMENTS?

• Efficacy of insecticidal pediculocides has decreased in recent years as head lice have developed resistance through natural selection. They are no longer considered the first-choice treatment. Physical insecticides are thought unlikely to encourage resistance and therefore to be a better choice.
• Wet combing requires heavy commitment and its efficacy is uncertain.
• The prophylactic spray has been found to be effective if the manufacturer’s directions are followed fully. No evidence regarding the effectiveness of the repellent spray appears to have been published.
• Apparent treatment failure with pediculocides is often suggested to be due to the ineffectiveness of the products, but it is more likely to be due to incorrect use or rapid re-infestation following successful treatment. It is therefore important to follow manufacturers’ directions carefully and to trace everyone with whom a person who is infested may have had head-to-head contact over the preceding few weeks, treating all those found to be infested. But there is no point in treating, for example, an entire family if one family member is infested, as pediculocides have no enduring prophylactic effect.

Activity

Consider how you might change your practice, staff training, and advice in relation to head lice after reading this article. Should you advise patients against using treatments of doubtful efficacy? Schedule a refresher staff training session on correct use of head lice products to ensure patients get the best value from their treatment.