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Home Remedies to Control Head Lice:: Assessment of Home Remedies to Control the Human Head Louse, Pediculus humanus capitis (Anoplura: Pediculidae)
Abstract
As the frequency and level of pediculicide resistance increases throughout the world, the need for novel solutions to control pediculosis has intensified. The development and registration of new pesticides has become so costly that many chemical companies are unwilling to pursue it and health-care providers now face a serious lack of new commercial pediculicides. Many infested people resort to using "home-remedy" approaches that have not been scientifically tested. In this article, we examined the potential value of six purportedly effective "home remedies" (vinegar, isopropyl alcohol, olive oil, mayonnaise, melted butter, and petroleum jelly) to treat head louse infestations and the likelihood of drowning lice by water submersion. Results indicated that only the application of petroleum jelly caused significant louse mortality but no treatment prevented lice from laying eggs. Most home remedy products did little to kill eggs, despite prolonged exposure. Petroleum jelly caused the greatest egg mortality, allowing only 6% to hatch. It was extremely difficult to drown lice, despite extended periods (i.e., 8 hr) of water submersion, suggesting that killing lice by depriving them of oxygen is inefficient. None of the home remedy products we surveyed was an effective means of louse control. This suggests that when treatment failure occurs, an increased amount of time and effort should be focused on alternative chemical pediculicides and/or manual louse removal (i.e., combing) rather than using any of these products.
... Shrivastava et al. [4] tried undiluted lemon which caused complete cessation of movements of lice adults after 25 min. Lee and his colleagues [5] tested olive oil in 2004. Tea Tree Gel appeared to have been quite effective in a study done by Heukelbach et al. [6]. ...
... Extra virgin olive oil appeared to be the least effective. The same was reported by Lee et al. [5] who declared that no home remedy killed 100% of lice or eggs after 24 hr. They also pointed out that olive oil might reduce egg hatchability. ...
... Negative control adults have remained alive throughout the whole exposure in agreement with other workers [4][5][6]. SEM of negative control has demarcated preserved outer smooth architecture which resembled the findings illustrated by Dutra et al. [10] who studied mummified adult lice. In that study, authors declared that adult lice showed a very well preserved state maintaining apparent lateral spiracles, eyes, and genital aperture in females. ...
Head lice, Pediculus humanus capitis, infestation is an important public health problem in Egypt. Inadequate application of topical pediculicides and the increasing resistance to the commonly used pediculicides made the urgent need for the development of new agents able to induce irreversible changes in the exposed lice leading to their mortality. The aim of the present work is to evaluate pediculicidal efficacy of some natural products such as olive oil, tea tree oil, lemon juice, and ivermectin separately in comparison with tetramethrin-piperonyl butoxide (licid), as a standard pediculicide commonly used in Egypt. The effects of these products were evaluated by direct observation using dissecting and scanning electron microscopes (SEM). Results showed that after 1 hr exposure time in vitro, absolute (100%) mortalities were recorded after exposure to 1% ivermectin and fresh concentrate lemon juice. The mortalities were decreased to 96.7% after exposure to tea tree oil. Very low percentage of mortality (23.3%) was recorded after 1 hr of exposure to extra virgin olive oil. On the other hand, the reference pediculicide (licid) revealed only mortality rate of 93.3%. On the contrary, no mortalities were recorded in the control group exposed to distilled water. By SEM examination, control lice preserved outer smooth architecture, eyes, antenna, respiratory spiracles, sensory hairs, and legs with hook-like claws. In contrast, dead lice which had been exposed to pediculicidal products showed damage of outer smooth architecture, sensory hairs, respiratory spiracles and/or clinching claws according to pediculicidal products used.
... At À1°C, body lice can survive for up to 67 h [4]. For head lice, there was only one previous study that reported a much higher mortality after water immersion (87% and a 100% death rate after 12 h and 16 h, respectively) [53]. Takano-Lee et al. [53] observed that 13% (n = 8) of head lice recovered following water immersion for 12 h, but that 100% (n = 20) of lice were killed after 16 h of immersion. ...
... For head lice, there was only one previous study that reported a much higher mortality after water immersion (87% and a 100% death rate after 12 h and 16 h, respectively) [53]. Takano-Lee et al. [53] observed that 13% (n = 8) of head lice recovered following water immersion for 12 h, but that 100% (n = 20) of lice were killed after 16 h of immersion. The fact that mortality was higher in untreated controls than in immersed lice may reflect the total immobility induced by water immersion; since water is not rapidly toxic for lice, the absence of movement reduces metabolic activity, which could otherwise be deleterious if combined with starving; in addition, control lice may also have suffered from dehydration. ...
Chemical, physical, and mechanical methods are used to control human lice. Attempts have been made to eradicate head lice Pediculus humanus capitis by hot air, soaking in various fluids or asphyxiation using occlusive treatments. In this study, we assessed the maximum time that head lice can survive anoxia (oxygen deprivation) and their ability to survive prolonged water immersion. We also observed the ingress of fluids across louse tracheae and spiracle characteristics contrasting with those described in the literature. We showed that 100% of lice can withstand 8 h of anoxia and 12.2% survived 14 h of anoxia; survival was 48.9% in the untreated control group at 14 h. However, all lice had died following 16 h of anoxia. In contrast, the survival rate of water-immersed lice was significantly higher when compared with non-immersed lice after 6 h (100% vs. 76.6%, p = 0.0037), and 24 h (50.9% vs. 15.9%, p = 0.0003). Although water-immersed lice did not close their spiracles, water did not penetrate into the respiratory system. In contrast, immersion in colored dimeticone/cyclomethicone or colored ethanol resulted in penetration through the spiracles and spreading to the entire respiratory system within 30 min, leading to death in 100% of the lice.
... The well-documented information for traditional head lice treatment, either with ethnobotanicals or other methods, is rather scarce. Products used in popular medicine include vinegar, formic acid, isopropyl alcohol, olive oil, mayonnaise, melted butter, propoleo, cupper oleate and petroleum jelly (Takano-Lee et al. 2004). How these products work can only be guessed, and none have been proved to effectively kill lice. ...
... Acids may act upon the nits by softening the protective sheath that covers and attaches the egg to the hair (Angel et al. 2000). Oily products may occlude the respiratory spiracles of the lice, or slow the insects making it easier to physically remove them with a fine comb (Takano-Lee et al. 2004). Veal (1996) reviews many home remedies described in recent aromatherapy books. ...
The head lice, Pediculus humanus capitis (Phthiraptera:Pediculidae), is an obligate ectoparasite of humans that causes pediculosis capitis, a nuisance for millions
of people worldwide, with high prevalence in children. Pediculosis capitis has been treated by methods that include the physical
remotion of lice, various domestic treatments and conventional insecticides. None of these methods render complete protection,
and there is clear evidence for the evolution of resistance and cross-resistance to conventional insecticides. Non-toxic alternative
options are hence needed for head lice treatment and/or prevention, and natural products from plants, especially essential
oils (EOs), are good candidates for safer control agents that may provide good anti-lice activity and low levels of evolved
resistance. A few EOs have been tested as repellents with promissory results, although often in vitro tests and clinical trials
produce contradictory results. A handful of fixed extracts and several EOs and their individual components have also been
tested as contact pediculicides or fumigants. The studies have focused mainly on plant families characterized for the production
of EOs. While many EOs and individual compounds showed pediculicide activity, comparing results is difficult due to the diverse
bioassay methodologies. Studies of anti-lice activity of individual EO components provide the basis for preliminary conclusions
of structure–activity relationships, although no clear patterns can yet be drawn. We here attempt to provide a concise compilation
of the available information on anti-lice activity of plant extracts and plant-derived compounds, which we hope may be of
help for future developments in this area.
... The well-documented information for traditional head lice treatment, either with ethnobotanicals or other methods, is rather scarce. Products used in popular medicine include vinegar, formic acid, isopropyl alcohol, olive oil, mayonnaise, melted butter, propoleo, cupper oleate, and petroleum jelly (Takano-Lee et al. 2004). How these products work can only be guessed, and none have been proved to effectively kill lice. ...
... Acids may act upon the nits by softening the protective sheath that covers and attaches the egg to the hair (Angel et al. 2000). Oily products may occlude the respiratory spiracles of the lice or slow the insects making it easier to physically remove them with a fine comb (Takano-Lee et al. 2004). Some studies that have searched for potential anti-lice products from plants have focused on repellent activity to prevent head lice infestation. ...
The head lice, Pediculus humanus capitis De Geer is an obligate ectoparasite of humans that causes pediculosis capitis, a nuisance for millions of people worldwide, with high prevalence in children. P. humanus capitis has been treated by methods that include the physical remotion of lice, various domestic treatments, and conventional insecticides. None of these methods render complete protection, and there is clear evidence for the evolution of resistance and cross-resistance to conventional insecticides. Non-toxic alternative options are hence needed for head lice treatment and/or prevention, and natural products from plants are good candidates for safer control agents that may provide good anti-lice activity. The plant extracts are good and safe alternatives due to their low toxicity to mammals and easy biodegradability. The present study carried out the pediculocidal activity using the hexane flower bud extract of Syzygium aromaticum (Myrtaceae) against P. humanus capitis examined by direct contact and fumigant toxicity (closed- and open-container methods) bioassay. The chemical composition of S. aromaticum flower bud hexane extract was analyzed by gas chromatography-mass spectrometry. The major chemical constituent (58.79%) of flower bud hexane extract S. aromaticum was identified as chavibetol (5-allyl-2-methoxyphenol) by comparison of mass spectral data and retention times. The hexane extract of S. aromaticum was subjected to gas chromatography analysis, and totally 47 compounds were detected, of which chavibetol was predominantly present. The other major constituents present in the hexane extract were eugenol acetate (phenol,2-methoxy-4-(2-propenyl)-,acetate (15.09%), caryophyllene-(I1) (2,6,10,10-tetramethyl bicyclo [7.2.0] undeca-1,6-diene (13.75%), caryophyllene oxide (3.04%), 2,6,6,9-tetramethyl-1,4,8-cycloundecatriene (1.67%), and copaene (1.33%). The filter paper contact bioassay study showed pronounced pediculicidal activity in the flower bud hexane extract of S. aromaticum. The toxic effect was determined for every five in an 80-min treatment. The result showed percent mortality of 40, 82, and 100 at 5, 10, and 20 min, and the median lethal time (LT(50)) value was 5.83 (0.5 mg/cm(2)); 28, 82, and 100 at 5, 10, and 30 min. (LT(50) = 6.54; 0.25 mg/cm(2)); and 13, 22, 42, 80, and 100 at 5, 10, 20, 40, and 80 min (LT(50) = 18.68; 0.125 mg/cm(2)), respectively. The vapor phase toxicity was tested at 0.25 mg/cm(2). There was a significant difference in pediculicidal activity of S. aromaticum extract against P. humanus capitis between closed- and open-container methods. Adult mortalities were determined for every five in 60 min (closed method) and for every ten in 180 min (open method). The closed method showed the percent mortality was 45, 88, and 100 at 5, 10, and 15 min (LT(50) = 5.39), respectively. In the open-container method, the percent mortality was observed 5, 20, 47, 84, and 100 at 10, 20, 60, 120, and 180 min (LT(50) = 47.91), respectively. The mortality was more effective in the closed containers than in open ones, indicating that the effect of hexane extract was largely a result of action in the vapor phase exhibited fumigant toxicity. Studies of anti-lice activity of extract provide the basis for preliminary conclusions of structure activity relationships; although no clear patterns can yet be drawn. We here attempt to provide a concise compilation of the available information on anti-lice activity of plant extracts and plant-derived compounds.
... In the literature, for the treatment of pediculosis, numerous methods are described with homebased formulations based on butter, oil, alcohol and petroleum, which expose the host to great risks. In order to verify the efficacy of these products, tests were performed [53], but the substance that presented an expressive mortality rate was only oil, while the other products presented only a decrease in egg fixation on the stem capillary, this thanks to its great viscosities facilitating the withdrawal with the fine comb. The treatment can be divided into two stages, where the first one aims at the death mainly of young and adult lice, in the subsequent application, between 7 and 14 days after the first, will occur the death of the parasites that will result from the hatching of the eggs that still exist. ...
Pediculosis is a common pathology in poor populations of several cities. However, it is even more incidental and neglected in riverine populations. Based on this assumption, this study proposed the collection of data on this disease in these populations, as well as the treatment through kits and demystification of the general aspects of this disease. According to the results, 71% of the individuals that participated in this research presented pediculosis; 69% of the cases occurred in the female sex; and more often in an age group of individuals between 9 and 12 years of age; in addition, it was observed that, of the individuals in this study, 34% used chemical methods to treat, through products purchased in pharmacy; and, worryingly, 38% did not use any method of treatment. As a result, massive intervention of the pharmacist as primary health agent in these riverside populations is necessary, in order to clarify the risks of the non-treatment of this pathology, as well as to clarify the indications of the best methods, and against indications of orthodox and non-orthodox, and still work in health education in schools, where are the individuals most frequently affected by pediculosis and in family health programs, together with community health agents, in the homes of individuals affected by this parasite. In addition, the creation of a portal of contact and doubts between affected families and the basic health units of the region.
... Furthermore, if a patient is evaluated post treatment and a false positive diagnosis is made, one could wrongly conclude that the treatment has failed. Therefore false positive diagnoses can also be a potential reason for 'treatment failure' (Takano- Lee et al. 2004). The diagnosis of pediculosis is based on two key elements: the diagnostic criteria and the diagnostic method.The only correct definition of an active infestation is the presence of a living, moving louse and/or viable eggs. ...
... Even whole coconut oil (melting point ~24 o Celsius) was shown ex vivo to have little activity until 4 hours had elapsed, eventually achieving 90% louse kill (7). In contrast, olive oil, which is mainly made up of unsaturated fats with a similar carbon chain length to those of coconut oil, was found to kill only 2% of lice after 8 hours (8). Irrespective of its chemical form, there is no evidence that small concentrations of either pure or modified fixed vegetable oils can have an effect on head lice, yet an internet search using the term "head lice vegetable oil" provided 1,830,00 responses, many of which were either advocating use of oils to kill lice or were advertising products containing oils. ...
Objective: Coconut oil and its derivatives are widely thought to kill head lice by occlusion and asphyxiation. There is no evidence in support of coconut derivative-based products sold to treat pediculosis. This study was designed to test one such product.
Methods: This was an open-label clinical study in 31 people. The treatment was shampoo containing 1% fractionated coconut oil. Treatment was given on day 0 and day 8. Efficacy was measured using a detection comb on day 1, day 8 and day 16 after the first
treatment. The trial was registered in the current controlled trials database, under number ISRCTN79136319.
Results: The first application of the product eliminated the lice from 7/31 participants, and 12/31 (38.7%) people had no lice at the end of the study. Lice of all development stages were found post treatment at all assessments on one or more participants. This
indicates that the treatment failed to kill all stages of the life cycle of head lice.
Conclusion: Two applications of the modified coconut shampoo were not effective at killing head lice or their eggs. The results confirm other studies that show little intrinsic activity in vegetable oils and modified oils. Most of the activity in shampoos is probably due to other product components, such as high levels of detergents.
Keywords: Head lice, coconut oil, shampoo, therapy
... However, there was a study that examined the potential value of six purportedly effective home remedies conducted by Takano-Lee et al. (2004). The common home-remedies examined included vinegar, isopropyl alcohol, olive oil, mayonnaise, melted butter, and petroleum jelly. ...
Background: Recurrent Pediculosis capitis may lead to various physical, economical and psychological consequences. The aim of the study was to determine the level of recurrent Pediculosis capitis, identify the factors associated with the recurrence and its predictors.
... In the literature, for the treatment of pediculosis, numerous methods are described with homebased formulations based on butter, oil, alcohol and petroleum, which expose the host to great risks. In order to verify the efficacy of these products, tests were performed [53], but the substance that presented an expressive mortality rate was only oil, while the other products presented only a decrease in egg fixation on the stem capillary, this thanks to its great viscosities facilitating the withdrawal with the fine comb. The treatment can be divided into two stages, where the first one aims at the death mainly of young and adult lice, in the subsequent application, between 7 and 14 days after the first, will occur the death of the parasites that will result from the hatching of the eggs that still exist. ...
... In conventional media, vinegar is consistently advised for curing head lice, nail fungus, and warts, even though further research regarding these eff ects is needed. Takano-Lee and colleagues [100] claimed that out of seven remedies examined, vinegar was the least useful for removing lice or suppressing the incubating eggs. Unproven statements have been made that the progressive topical utilization of extremely congregated acetic acid mixtures (up to 99 %) mitigated warts [101,102], apparently because of the mechanical levigation of wart tissue. ...
While the use of vinegar to fi ght against infections and other crucial conditions dates back to Hippocrates, recent research has foundthat vinegar consumption has a positive effect on biomarkers for diabetes, cancer, and heart diseases. Different types of vinegar have been
used in the world during different time periods. Vinegar is produced by a fermentation process. Foods with a high content of carbohydrates area good source of vinegar. Review of the results of different studies performed on vinegar components reveals that the daily use of these components has a healthy impact on the physiological and chemical structure of the human body. During the era of Hippocrates, people used vinegar as a medicine to treat wounds, which means that vinegar is one of the ancient foods used as folk medicine. The purpose of the current reviewpaper is to provide a detailed summary of the outcome of previous studies emphasizing the role of vinegar in treatment of different diseasesboth in acute and chronic conditions, its in vivo mechanism and the active role of different bacteria.
... With the use of essential oils, there is a trade-off between efficacy and irritancy [1][2][3], and some materials approved for use against head lice have been implicated in potentially life threatening reactions in a small number of people [4,5]. Alternative natural materials with low irritancy, such as fixed oils, used in cosmetics, home remedies, and some commercial products, generally show low levels of efficacy against head lice [6,7]. The most widely used fixed oils are derived from the neem tree Azadirachta indica A. Juss (Meliaceae). ...
Background: Neem oil and wet combing with conditioner are both claimed to facilitate elimination of head louse infestation. The aim of this pilot study was to identify whether a 1% neem oil lotion showed activity itself and/or enhanced the effectiveness of combing in treating infestation.
Methods: We treated 47 participants with 1% neem-based lotion on four occasions 3-4 days apart in a randomised, community based trial, analysed by intention to treat. The participants were randomly divided between two groups: One group used a grooming comb (placebo) and the other a head louse detection and removal comb (wet combing with conditioner method) to systematically comb the hair. Cure was defined as no lice on both Day 10 and Day 14.
Results: The cure rates of 6/24 (25.0%) for the placebo comb group and 8/23 (34.8%) for the louse comb group were not significantly different.
Conclusion: These results indicate that this formulation of neem oil was ineffective in the treatment of head louse infestations, even when accompanied by combing. Both combing methods were also ineffective, despite being implemented throughout by trained professionals.
... Home remedies such as petroleum jelly, olive oil, and mayonnaise have been found to be ineffective ex vivo (2,46). These therapies may transiently suppress louse metabolic activity, giving the false impression of death, only to have them awaken shortly thereafter-the so-called "resurrection effect" (31). ...
Unlabelled:
Head lice are a source of scalp irritation, social disruption, and loss of school time. Health care providers need authoritative information to help avoid the costs and risks of ineffective treatment. A review was completed to provide relevant information on infestation treatments available in the United States. Three major biomedical databases were searched from 1985, when current products were first available, to 2014, focusing on U.S.
Reports:
A total of 579 references remained after duplicates were removed. A search of the U.S. Food and Drug Administration website and labels of approved products were reviewed. A marked decline in the effectiveness of permethrin and synergized pyrethrins was found, probably because of resistance arising from widespread and indiscriminate use, and the emergence of knockdown resistance mutations. The potential toxicity of lindane in the setting of readily available, safer, and more effective alternatives, should limit its use. Prescription products shown to be safe and effective with a single application, without nit combing, are topical ivermectin, malathion, and spinosad, whereas benzyl alcohol requires two applications. Home remedies such as mayonnaise, and essential oils, have not been demonstrated to be safe or effective, and may carry potential for severe adverse events. The high risk of failure of over-the-counter treatments in eliminating head louse infestations drives a need for health care provider recognition of the limitations of current treatments and for judicious use of treatments that remain effective.
... (Stortz and Marangoni 2014) However, still today, the use of petrolatum is quite widespread and can almost be regarded as a household panacea. Beyond its use in hair-relaxing kits, it has historically been used in an array of common applications such as a moisturizer for dry/chapped skin (Alekseev, Szabo, and Ziskin 2008) and dressing for burns and other wounds (Wilson et al. 1986;Guilbaud 1992;Nijhawan, Smith, and Mariwalla 2013), even to treat head lice (Takano-Lee et al. 2014). In addition, others have reported some quite novel uses in the areas of surgery (Browning 2006), material fabrication (Jones, Billington, and Pearson 2007) and, recently, it has even been noted of use in the treatment of constipation in hospice patients (Tavares et al. 2014). ...
Hair relaxing kits are used by many women, a high percentage of whom are African American, to transform curly hair to straight. Almost all varieties consist of extremely caustic solutions that demonstrate pH values in the range of 10 to 14. Because of the harshness of this alkaline reagent, petroleum jelly (petrolatum) is often times incorporated into the composition to protect the scalp. Petrolatum, a highly organic by-product of crude oil, is widely used in cosmetics and topical pharmaceuticals as well. This paper reports the elemental composition of various brands of hair-relaxing creams. Several sample preparation techniques were investigated for the digestion of this very organic, viscous matrix. Inductively coupled plasma - mass spectrometry (ICP-MS) was employed for its multielement capability and high sensitivity. Internal standard calibration was used in the quantitation of a select group of metals, transition metals, and metalloids (Ti, V, Cr, Co, Ni, Ga, Ge, As, Se, Rb, Sr, Zr, Nb, Mo, Ag, Cd, Cs, Ba, W, Re, Tl, Pb, U) and the established method was applied to various brands of hair-relaxing kits. Major elemental constituents were Ti, Sr, and Ba and these were found at low µg g−1 in all brands considered.
... These developments also included non-volatile fixed vegetable oils, with anecdotal claims of effectiveness for olive oil, mayonnaise, margarine, and coconut oil, which are messy to use and have doubtful effectiveness. Unmodified plant oils have been used for centuries as hair conditioners in southern Europe, South Asia, and Africa, without affecting lice as confirmed by laboratory tests of so-called " home remedies " (Takano-Lee et al., 2004). However, modified vegetable oil surfactants are widely used in toiletry cleansing products to remove oils and other materials from hair. ...
Context. During the late 1990s, insecticide resistance had rendered a number of treatment products ineffective; some companies saw this as an opportunity to develop alternative types of treatment. We investigated the possibility that a surfactant-based lotion containing 10% cocamide diethanolamine (cocamide DEA) was effective to eliminate head louse infestation.
Settings and Design. Initial in vitro testing of the lotion formulation versus laboratory reared body/clothing lice, followed by two randomised, controlled, community-based, assessor blinded, clinical studies.
Materials and Methods. Preliminary laboratory tests were performed by exposing lice or louse eggs to the product using a method that mimicked the intended use. Clinical Study 1: Children and adults with confirmed head louse infestation were treated by investigators using a single application of aqueous 10% cocamide DEA lotion applied for 60 min followed by shampooing or a single 1% permethrin creme rinse treatment applied to pre-washed hair for 10 min. Clinical Study 2: Compared two treatment regimens using 10% cocamide DEA lotion that was concentrated by hair drying. A single application left on for 8 h/overnight was compared with two applications 7 days apart of 2 h duration, followed by a shampoo wash.
Results. The initial laboratory tests showed a pediculicidal effect for a 60 min application but limited ovicidal effect. A longer application time of 8 h or overnight was found capable of killing all eggs but this differed between batches of test material. Clinical Study 1: Both treatments performed badly with only 3/23 (13%) successful treatments using cocamide DEA and 5/25 (23.8%) using permethrin. Clinical Study 2: The single overnight application of cocamide DEA concentrated by hair drying gave 10/56 (17.9%) successes compared with 19/56 (33.9%) for the 2 h application regimen repeated after 1 week. Intention to treat analysis showed no significant difference (p = 0.0523) between the treatments. Over the two studies, there were 18 adverse events possibly or probably associated with treatment, most of which were increased pruritus after treatment.
Conclusions. Cocamide DEA 10% lotion, even when concentrated by hair drying, showed limited activity to eliminate head louse infestation.
... Evaluation of several home remedies (vinegar, isopropyl alcohol, olive oil, mayonnaise, melted butter, and petroleum jelly) revealed that the use of petroleum jelly caused the greatest egg mortality, allowing only 6% to hatch. [64] A 96% cure rate has been reported with a suffocation-based pediculicide lotion applied to the hair, dried on with a hand-held hair dryer, left on overnight, and washed out the next morning. The process must be repeated once per week for 3 weeks. ...
An endeavour to delineate the salient details of the treatment of head lice infestation has been made in the present article. Treatment modalities including over the counter permethrin and pyrethrin, and prescription medicines, including malathion, lindane, benzyl alcohol, spinosad are discussed. Salient features of alternative medicine and physical treatment modalities are outlined. The problem of resistance to treatment has also been taken cognizance of.
... headliceinfo.com/treat.htm), although laboratory investigation has shown little or no activity (Takano-Lee et al., 2004). Other traditional treatments include sassafras oil (from Sassafras spp.) with the active substance safrole (5-(2-propenyl)-1,3-benzodioxole), which is also a carcinogen; and lousebane, Delphinium staphysagria, extracts, which contain the active diterpenoid alkaloid delphinine (Busvine, 1946). ...
Head lice, Pediculus humanus capitis, are blood-feeding ectoparasitic insects of the Order Phthiraptera found only on the scalps of humans. Since the time when humans started civilised communities, there have always been products based on plant extracts sold for treating head louse infestation. Many of these were derived from traditional herbal practice and the folklore surrounding various aromatic plants, but also included the fixed oil (oils obtained by pressing rather than distillation) derivatives from other plant groups. Some such as olive and coconut oils have been used as grooming aids and hair conditioners for centuries in their countries of origin where they quite clearly have little impact on lice given the levels of endemic pediculosis (Gratz, 1998), but recently some organisations elsewhere have suggested they may have potential for limiting the levels of infestation, although laboratory investigation has shown little or no activity. Other traditional treatments include sassafras oil (from Sassafras spp.) with the active substance safrole (5-(2-propenyl)-1,3-benzodioxole), which is also a carcinogen; and lousebane, Delphinium staphysagria, extracts, which contain the active diterpenoid alkaloid delphinine. So many traditional products are generally either ineffective or potentially hazardous. Following the appearance of multiple forms of insecticide resistance in head lice during the 1990s, the pharmaceutical industry gradually came to the conclusion that products with alternative modes of action were necessary to deal with the increasing level of infestation that was apparent in many communities. In Europe, and more recently Australia, the response to the problem has been primarily directed at development of non-pharmacological methods of treatment, i.e. treatments that are deemed by regulators not to exert a pharmacological effect on the human and which have a physical or chemical mode of action that does not cross the skin barrier. The most basic of these had been a renewed interest in combing to remove lice and their eggs physically but, because a majority of people appear to prefer the simpler approach of a topical treatment, various chemical “active” substances have also been developed that are marketed as having no direct physiological activity. The first products to appear as alternatives to insecticides originated in Central Europe in the late 1980s and mostly claimed to be coconut based; in reality they were mainly surfactant mixes that at some point in their chemical history included a modified coconut derivative. At the time the regulatory status of these preparations was somewhat obscure, being initially sold as “herbal” remedies, and from the mid-1990s they were able to take advantage of the European Community Medical Devices legislation. This process of developing products based on natural substances expanded from using essential oils from the aromatic herbs such as rosemary, thyme, and lavender, and those fixed oils with historical uses in Europe such as olive, grape seed, and coconut oils to include more exotic materials such as oil and extracts from the neem tree, Azadirachta indica, and its close relatives, various other tropical fixed oils, and essential oils from tropical herbs and spices.
... Their incidence varied around the world depending on type and place of living. Ectoparasitic infestation can be as sporadic, endemic or epidemic [1]. ...
This cross-sectional study was performed on all patients suspected to be suffering from ectoparasites who were referred to the parasitology laboratory of Imam Reza Hospital of Mashhad during 15 years (April 1995 to April 2010). All patients' data were collected from the questionnaires and then analyzed statistically. From 1814 suspected patients to be suffering from ectoparasites, 375 patients had scabies and, 99 suffer from pediculosis. The mean age of patients was 26/18 ± 17/68. The most common age of scabies was 10-19 (27/7%) and pediculosis 0-9(9/6%) (P value = 0.00). The highest incidence of pediculosis was in women (3.6%) and scabies in men (13.7%) (P value = 0.00). Pediculosis is more common in children (9/9%) and scabies in workers (32%)(P value = 0.00). Scabies and pediculosis were more prevalent in patients from Razavi Khorasan Province with 18.7% and 5%, respectively (P value = 0.08).
... Ectoparasitic infestations can be sporadic, endemic or epidemic. 1 Pediculosis is an ectoparasitic infestation caused by Pediculus capitis (head lice), which is inhabitant of the scalp and hair of humans and causes severe itching to the host. 2 Head lice infestation is a growing and persistent problem. 3 It is a common chronic disease which affects the children of school age with varying degree of prevalence in developed countries, 8.9% in Ghent, Belgium and 0-28% in Victoria, whereas in developing countries 81.5% in Argentina, 58.9% in Alexandria, Egypt. 4 After every few hours the head lice taking tiny amounts of blood from the scalp of the host by injecting small amounts of saliva into the host. Heavy infestations and frequent feeding of the lice may lead to iron deficiency and subsequent anemia. ...
... Each treatment was applied twice, seven days apart, and cure rates were similar in the two groups (70 and 75%, respectively). The authors state that dimeticone and the volatile silicone base it was dissolved in (cyclomethicone) are extensively used in cosmetics and toiletries (Takano-Lee et al, 2004). ...
Lice infestation on the human body (also known as pediculosis) is very common. Cases number in the hundreds of millions worldwide. Three distinct presentations of lice infection exist and each is caused by a unique parasite. Head lice (Pediculus humanus capitis) is by far and away the most common infestation and favors no particular socioeconomic group. A genetically close "cousin," Pediculus humanus corporis, is responsible for body lice and is more commonly associated with poverty, overcrowding, and poor hygiene. Pubic lice (crabs) are caused by Pthirus pubis and is transmitted by intimate and/or sexual contact. No doubt, human lice infestation is an increasing problem worldwide, Apart from being an irritating and a shaming human ecto-parasite, they transmit serious infectious diseases; epidemic or classical typhus, epidemic relapsing fever as well as Trench fever. Eradication of lice infestation prevents transmission of infectious diseases. People who live and work in close proximity to louse-infested individuals may secondarily acquire lice even if they regularly wash their clothes and have good hygiene. Thus, all louse-infested persons and workers in close contact with such persons should periodically inspected and use long-acting safe insecticides. Human lice can be treated with agents such as DDT, malathion, and lindane, but reports of resistance to one or more of them have recently appeared. Pyrethroid permethrin when applied as a dust or spray to clothing or bedding is highly effective against lice and is the delousing agent of choice. Fabric treated with permethrin retains toxicity to lice even after 20 washings, thereby offering significant long-term passive protection against epidemic typhus. Itching may continue even after all lice are destroyed. This happens because of a lingering allergic reactionto their bites. Over-the-counter cortisone (corticosteroid) creams or calamine lotion may help.
... Each treatment was applied twice, seven days apart, and cure rates were similar in the two groups (70 and 75%, respectively). The authors state that dimeticone and the volatile silicone base it was dissolved in (cyclomethicone) are extensively used in cosmetics and toiletries (Takano-Lee et al, 2004). ...
Most insect bites cause local inflammatory reactions that subside within a few hours. However, more severe local symptoms, transmission of a disease-causing pathogen, and systemic allergic reactions are also possible. Mosquito bites can cause varying degrees of local swelling, papular urticaria in children, and rare systemic allergic reactions, including anaphylaxis. Papular urticaria is a hypersensitivity reaction most often seen in children following mosquito and flea bites, although a variety of other bites have been implicated in smaller numbers of reports. Systemic allergic reactions can occur in response to the bites of mosquitoes, several types ofblood-sucking flies, fleas, kissing bugs, lice, and ticks.
... Oral dimeticones are used as anti-flatulents to alleviate gastrointestinal discomfort. Non-insecticidal treatment options against head lice infestations are limited and include some natural products with good efficacy [28,29], but also physical methods and home remedies with rather low efficacy, such as combing with a fine tooth comb or application of vinegar3031323334. The dimeticone product, being highly efficacious and non-toxic, can be considered an ideal pediculicide. ...
Infestation with the human head louse (Pediculus humanus capitis) occurs worldwide. Existing treatment options are limited, and reports of resistance to commonly used pediculicides have been increasing. In this trial we assessed the efficacy of a product containing a high (92%) concentration of the silicone oil dimeticone (identical in composition to NYDA(R)), as compared to a 1% permethrin lotion.
Randomized, controlled, observer blinded clinical trial. Participants were recruited from a poor urban neighbourhood in Brazil where pediculosis capitis was highly prevalent. To minimize reinfestation during the trial, participants (145 children aged 5-15 years with head lice infestations) were transferred to a holiday resort outside the endemic area for a period of 9 days. Two applications of dimeticone or 1% permethrin were done, seven days apart. Outcome measures were defined as cure (absence of vital head lice) after first application and before and after second applications, degree of itching, cosmetic acceptability, and clinical pathology.
Overall cure rates were: day 2 - dimeticone 94.5% (95% CI: 86.6% - 98.5%) and permethrin 66.7% (95% CI: 54.6% - 77.3%; p < 0.0001); day 7 - dimeticone 64.4% (95% CI: 53.3% - 75.3%) and permethrin 59.7% (95% CI: 47.5% - 71.1%; p = 0.5); day 9 - dimeticone 97.2% (95% CI: 90.3% - 99.7%) and permethrin 67.6% (95% CI: 55.4%-78.2%); p < 0.0001). Itching was reduced similarly in both groups. Cosmetic acceptability was significantly better in the dimeticone group as compared to the permethrin group (p = 0.01). Two mild product-related incidents occurred in the dimeticone group.
The dimeticone product is a safe and highly efficacious pediculicide. Due to its physical mode of action (interruption of the lice's oxygen supply of the central nervous system), development of resistance is unlikely.
Current Controlled Trials ISRCTN15117709.
... However, many chemical companies are unwilling to pursue potential new pesticides due to the high costs associated with development and registration. As a result, families are often trying untested home remedies with generally ineffective outcomes [31]. Recently, as for scabies, oral ivermectin has been identified as an effective pediculicide in polyparasitized communities [12]. ...
Ectoparasitic infestations are highly prevalent in resource-poor populations throughout the world and are associated with considerable morbidity. Reliable data on the epidemiology, immunology, and therapy of ectoparasitic infestations and on the biology of the parasites remain scarce. The control of parasitic skin diseases, such as scabies, pediculosis, tungiasis, myiasis, and cutaneous larva migrans in endemic areas remains a challenge. Using appropriate study designs, it is imperative to increase further the knowledge on the various aspects of the parasites and the infestations they cause.
... Parents use an assortment of "treatments" ranging from bug spray to mayonnaise to kerosene. 16 These remedies can harm the child, and there is little hard evidence to indicate that they are effective. In short, an effective new approach for treating head lice is sorely needed. ...
Head lice (Pediculus humanus capitis) are a major irritant to children and their parents around the world. Each year millions of children are infested with head lice, a condition known as pediculosis, which is responsible for tens of millions of lost school days. Head lice have evolved resistance to many of the currently used pediculicides; therefore, an effective new treatment for head lice is needed. In this study we examined the effectiveness of several methods that use hot air to kill head lice and their eggs.
We tested 6 different treatment methods on a total of 169 infested individuals. Each method delivers hot air to the scalp in a different way. We evaluated how well these methods kill lice and their eggs in situ. We also performed follow-up inspections to evaluate whether the sixth, most successful, method can cure head louse infestations.
All 6 methods resulted in high egg mortality (> or = 88%), but they showed more-variable success in killing hatched lice. The most successful method, which used a custom-built machine called the LouseBuster, resulted in nearly 100% mortality of eggs and 80% mortality of hatched lice. The LouseBuster was effective in killing lice and their eggs when operated at a comfortable temperature, slightly cooler than a standard blow-dryer. Virtually all subjects were cured of head lice when examined 1 week after treatment with the LouseBuster. There were no adverse effects of treatment.
Our findings demonstrate that one 30-minute application of hot air has the potential to eradicate head lice infestations. In summary, hot air is an effective, safe treatment and one to which lice are unlikely to evolve resistance.
... 4 Olive oil showed itself ineffective in killing adult females even when these were submerged in the oil. 31 These results are in marked contrast to those observed with M azedarach L. oil. Other natural products, such as essential oils from eucalyptus, 17,18 marjoram, pennyroyal, spearmint, peppermint, sage, cade, myrtle, rosewood and rosemary, clove bud and leaf, 18 and cinnamon bark 32 have exhibited adulticidal activity against lice in filter paper contact bioassays, with eucalyptus, marjoram, pennyroyal and rosemary oils at 1.23% being the most effective in comparison to d-phenothrin and pyrethrum. ...
Head louse infestation is difficult to control because of increasing lice resistance to synthetic pediculicidal drugs.
To test the activity of extract and oil obtained from fruits of Melia azedarach L. against the head louse Pediculus humanus capitis.
A filter paper diffusion bioassay was carried out in order to determine the pediculicidal and ovicidal activity of extract and oil from M azedarach L. fruits.
Both vegetable products, tested either individually or in combinations, showed high levels of mortality on adult lice, with values ranging between 62.9% and 96.5%. The highest mortality rate was obtained with a combination of 20% ripe fruit extract with 10% ripe fruit oil. A formulation made with both extract and oil at 10% plus the addition of emulsifier and preserving agents showed 92.3% pediculicidal activity. The products were also successful in delaying or inhibiting nymph emergence, with the formulation being the most effective, with a complete inhibition of emergence.
Because adult lice are sensitive to starvation and therefore control mortalities are often higher than 20% in tests with field specimens, the results may not reflect the direct effect of the extract.
These results demonstrate the possibility of using Melia products for controlling head lice, which are difficult to control because of their resistance to the currently used anti-louse agents.
... This means that innocuous or highly toxic substances can be used by the population, sometimes causing cases of intoxication. 42,43 Household remedies, such as vinegar, alcohol, and various oily substances, were inefficient in controlling P. capitis in the laboratory, 44 although vinegar was demonstrated to be a moderate agent that could aid in the removal of nits. 45 Reinfestation or the lack of control in 43% of residences was one of the reasons leading to the increase in substance associations, a practice that can heighten the risk of intoxication. ...
Head lice constitute a problem in children. Each year, numerous cases of pediculosis occur worldwide. Little work has been performed to evaluate the understanding, opinions, and actions of populations regarding head lice. These areas are important as they enable clinicians and educators to alert parents on how to avoid treatments that are innocuous or of high risk to patients.
A cross-sectional study was performed by interviewing the heads of households of 100 randomly chosen residences within the study area.
The results obtained showed that 13% were infested during the first week of the survey, and 86% in the 24 weeks prior to the study. The number of positive cases increased with increasing resident number, and decreased in families with parents with a higher educational level. Itching was the principal clinical manifestation and caused sleep compromise in 65% of respondents. Innocuous and unhealthy practices to combat infestation, such as the use of inflammables and home insecticides, were common.
The results showed that certain beliefs generated worry and confusion in parents, who blamed head lice as the cause of various health problems which were not due to this insect.
Purpose
This study examined the impact, trends, and impact levels of factors affecting Pediculus capitis infestation in primary school students.
Subject and methods
Among the papers reviewed, 226 were selected, as they contained information that suited the study objectives.
Results
The factors whose trends have higher gradients have a higher impact on the infestation level. In order of impact, the gradients of hair washing frequency, health instructor involvement, bathing frequency, mother's and father's education, existence of bathing facility, family size, hairstyle, and family income trends are higher than hair length, and age and education trends. As a result, the factor impacts are diminished from the beginning to the end. The importance of the family size, father's and mother's education, bathing facility existence, health instructor involvement, and bathing and hair washing frequency factors, whose trends increased over time, is higher than family income, hairstyle and length, and age and education, whose trends remained constant or decreased. Based on the gradient of the factor level impact trends, it seems that hair washing frequency, father's and mother's education, and health instructor involvement are the factors with the greatest effects on infestation level, in that order. These are followed by the influence of family income and size, and hairstyle factors. The existence of bathing facilities, bathing frequency, hair length, and education factors have weaker effects.
Conclusion
This work provides the importance and impact levels of factors affecting Pediculus capitis infestation levels in primary school students, which will help meet the needs of policymakers.
There is an observed increase in the numbers of patients presenting to hair stylists and dermatologists with human head lice. Infrequent hair washing, sharing of combs within the home and at the hair salon is known to contribute to transmission of this ectoparasite. It has been noticed that a significant number of those affected have natural untreated hair suggesting that chemical straighteners used in the past may have reduced the presence of head lice . Apart from the discomfort and stigmatization associated with head lice it had also been associated with some re-emerging infections emphasizing the need for awareness on this rising trend. A high index of suspicion together with appropriate diagnostic acumen is necessary to identify human headlice infestation especially in the natural black African hair with its peculiarities. We have observed that many patients have resorted to using chemical hair straighteners in an attempt to treat and prevent head lice infestation due to anecdotal reports and general belief of the population of its effectiveness. There is a need for proper treatment of this condition so as to prevent the unwanted side effects of these chemicals.
Head lice are a public health problem and resistance to over-the-counter medications is a source of concern for many. The current study was conducted to evaluate the activity of three plants as a natural alternative to medical pesticides to treat pediculosis in Najaf province ,Iraq. It was noted that the Lawsonia Inermis plant (Henna paste) mixed with mercury has scored the highest effectiveness for killing lice in two hours from the first use by 100% followed by the Allium cepa juice mixed with Curcuma longa plant, where the rate of killing 80% of the second use and finally vinegar mixed with sodium chloride (food salt) by 46.66%. our suggestion that these blended Materials give better results than if they were alone and are excellent alternatives to medical pesticides
All species of Phthiraptera are strongly stenoxenous ectoparasites on birds and mammals. They spend their entire life cycle on the host. Many species are of veterinary importance, but only three are ectoparasites of humans – the head louse Pediculus humanus capitis, the clothing louse Pediculus humanus humanus and the crab louse Pthirus pubis. The clothing louse is important as main vector of Rickettsia prowazekii, Borrelia recurrentis and Bartonella quintana. Its prefered habitat is clothin. Long-term survival of the clothing louse is only possible when infested clothes are worn longer periods of time in the absence of sufficient desinsection measures such as washing or storage. The head louse infests scalp hair. It is widespread the world over, among all social Groups and especially among children. The crab louse Pthirus pubis is mainly found in pubic hair. It is usually transmitted by close bodily contact, such as during sexually intercourse, and occurs more rarely.
Head and crab lice, as well as animal lice, can be eradicated only by efficient and repeated lice control measures that include repeated applications of pediculicid medications having a high anti-lice efficacy. To treat human lice, various pediculicids are available with classical and alternative modes of action. Additional steps to effectively control lice and to guard against lice-borne diseases are information, attention, early diagnosis, contact tracing and hygienic measures.
Remineralization is defined as the process whereby calcium and phosphate ions are supplied from a source external to the tooth to promote ion deposition into crystal voids in demineralized enamel to produce net mineral gain. The remineralization produced by saliva is less and also a slow process, therefore remineralizing agents are required.The aim of the study was to check the remineralizing efficacy of commercially available homeopathic dentifrice on enamel micro hardness of primary teeth and to compare the remineralizing potential of commercially available fluoridated dentifrice and non-fluoridated homeopathic dentifrice.A total of 20 teeth were sectioned into equal parts with a diamond disc. The 40 sections obtained were then evaluated under the Vickers microhardness indenter for baseline microhardness of enamel. The 40 Sections coated with a nail varnish leaving a window of 1 mm were subjected to demineralisation for 72 hours.The sections were then again evaluated under the Vickers microhardness indenter and the hardness after the demineralisation noted. The 40 sections were divided into 2 groups: Group 1-Kidodent(child formula fluoride dentifrice), Group 2-Fresh gel(non fluoridated homeopathic dentifrice) and subjected to remineralisation respectively for 7 days. The specimens were again evaluated under the vickers microhardness indenter for the remineralisation values. The remineralising values were significantly higher in Kidodent group than Fresh gel.Based on the results obtained from the present study, the child formula dentifrices containing NaF have the ability to remineralize the initial carious lesions in the primary teeth. There is need for more studies with different ABSTRACT RESEARCH ARTICLE 12075 analytical techniques to study the remineralisation potential of the homeopathic dentifrice and compare them with the other remineralizing agents.
Head louse infestation is a worldwide public health problem that affects some people mostly school age children. This survey was a descriptive, analytical study that carried out to evaluate and determine the prevalence rate of pediculosis capitis and some associated factors among primary schoolchildren in Bayengan city, Kermanshah Province, Iran. 384 students in 4 schools (164 boys and 220 girls) were selected. For data collection, Random Cluster Sampling Method was used and from each cluster 96 persons were selected. The results and demographic data, was recorded in a questionnaire and then analyzed by SPSS ver. 16. The results of the study showed that 54 students (14.1%) were infested. 8.5% of the boys and 18.2% of the girls were infested to head lice. The most prevalent rate was observed in grade five and the lowest prevalence rate was observed in grade I. There were significant statistical differences between pediculosis capitis and some factors such as sex, level of mother's education and father's job (p<0.05). The prevalence rate of head louse infestation in this study was high. The educational system should clarify all of parents from all families to play a more effective role to eliminate head louse infestation among schoolchildren.
Many arthropod species are capable of inflicting bites and stings on humans. They produce their effects on the skin by a variety of mechanisms, resulting in a wide spectrum of clinical lesions. Reaction to arthropod assaults can range from mild to life threatening. Diagnosis of arthropod bites is often self-evident, but may be difficult when the source of the bites is not immediately obvious. An entomologist is often invaluable in these situations. Many diseases have arthropods vectors, for example malaria (mosquitoes), leishmaniasis (sandflies) and typhus (lice). The terrestrial arthropods of medical interest include the orders Insecta (insects), Arachnida (arachnida), Chilopoda (centipedes) and Diplopoda (millipedes).
An estimated 6 to 12 million children are affected by lice annually in the United States.(1) Knowledge of the various treatment options for this diagnosis is essential. This paper aims to provide an overview of the myriad therapeutic options available for lice infestations in children. U.S. Food and Drug Administration-approved drugs, off-label drug therapies, over-the counter-products, and herbal remedies are all discussed in detail. Clinicians may use this information to teach patients and families about the latest available care for the eradication of head lice in pediatric patients.
Copyright © 2015 Elsevier Inc. All rights reserved.
Abstract: Head louse infestation is a worldwide public health problem that affects some people mostly school age children. This survey was a descriptive, analytical study that carried out to evaluate and determine the prevalence rate of pediculosis capitis and some associated factors among primary schoolchildren in Bayengan city, Kermanshah Province, Iran. 384 students in 4 schools (164 boys and 220 girls) were selected. For data collection, Random Cluster Sampling Method was used and from each cluster 96 persons were selected. The results and demographic data, was recorded in a questionnaire and then analyzed by SPSS ver. 16. The results of the study showed that 54 students (14.1%) were infested. 8.5% of the boys and 18.2% of the girls were infested to head lice. The most prevalent rate was observed in grade five and the lowest prevalence rate was observed in grade I. There were significant statistical differences between pediculosis capitis and some factors such as sex, level of mother’s education and father’s job (p<0.05). The prevalence rate of head louse infestation in this study was high. The educational system should clarify all of parents from all families to play a more effective role to eliminate head louse infestation among schoolchildren.
Abstract
Background: Pediculus capitisor head louse infestation affects millions of children worldwide, especially those in
the 5–11 years age group. This study aimed to determine the prevalence of head pediculosis among school children in
urban and rural areas of Fars Province, southern Iran.
Methods:All school children of age 6-11 yr from both genders in all urban and rural areas of the province were
screened for head louse infestation by examination of their hair and scalps. Parents of all infested children were also
examined. The study was repeated in different seasons in the same areas. Moreover, infested children were treated
with 5% permethrin shampoo and re-examined one weeklater for any relapse.
Results:The general prevalence of head louse infestation in primary school students was 0.49% in autumn, 0.37% in
winter and 0.20% in spring. In the mentioned seasons, the prevalence of P. capitiswas higher among females and in
rural areas (P=0.001). Although treatment with permethrin shampoofailed in females, it was successful in all infected
males from both regions in autumn and spring and inmales from urban areas in winter.
Conclusion:Head louse infestation is uncommon among Fars Province school children in rural and urban areas and
should not be considered a public health priority. However, due to the higher prevalence of pediculosis in low
socioeconomic group and rural area in our region, it seems that health promotion, particularly early detection and
effective management strategies should target this group in the province
Head lice are transmitted by head to head contact. Optimal therapy includes malathion lotion 0.5% repeated in one week left on for 30 minutes to 8 hours. Spinosad topical suspension 0.9% repeated in one week left on for 10 minutes is another option. Scabies is transmitted mainly by direct contact but also via heavily infested fomites due to crusted scabies. Permethrin 5% cream to the body repeated in four days is often sufficient; however, scalp treatment with malathion lotion 0.5% is helpful in crusted scabies and in infested children. Oral ivermectin 200 mcg/kg is another option, repeated in four days. For scabies more than lice, fomites should be placed in a drier at 60 °C for 10 minutes to kill the arthropods. Treatment of close contacts in both cases will control outbreaks and repeated infestations. Both have been associated with methicillin-resistant Staphylococcus aureus infection. Bed bugs are a common cause for papular urticaria. Identification of the insect in the mattress or bedding confirms the diagnosis. Prevention involves encasing the mattress in a sealed plastic cover and extermination. Delusions of parasitosis is a diagnosis of exclusion that is best treated with an antipsychotic.
Head lice infestation is associated with limited morbidity but causes a high level of anxiety among parents of school-aged children. Since the 2002 clinical report on head lice was published by the American Academy of Pediatrics, patterns of resistance to products available over-the-counter and by prescription have changed, and additional mechanical means of removing head lice have been explored. This revised clinical report clarifies current diagnosis and treatment protocols and provides guidance for the management of children with head lice in the school setting.
The purpose of this project was to formulate an effective change strategy for head lice management in a group of five separate school districts within one county. Despite a desire to use evidence to support their practice, school nurses often encounter educational system barriers that prevent independent management of health conditions. The use of collaborative community relationships, identification of underlying hierarchy structures in school policy development, and targeted system education were the catalysts for changing beliefs and ultimately policy within these school districts. The focus of this project was to develop a policy change strategy for head lice. The strategy provides direction for successful health policy advocacy using evidence-based practices for other health issues within the education setting.
Based on the dialogue "Head lice" between Drs Kimberly D. Morel and Stephen Stone. Dialogues in Dermatology, a monthly audio program from the American Academy of Dermatology, contains discussions between dermatologists on timely topics. Commentaries from Dialogues Editor-in-Chief Warren R. Heymann, MD, are provided after each discussion as a topic summary and are provided here as a special service to readers of the Journal of the American Academy of Dermatology.
Scabies and pediculosis are ubiquitous, contagious, and debilitating parasitic dermatoses. The tendency of high prevalence of pediculosis and scabies among school and preschool age children has prompted us to conduct a head louse and scabies prevalence survey among preschool nursery children in our district. A school-based, crosssectional study was performed, with 1,134 children chosen for evaluation. All cases were evaluated by physical examination and a detailed, structured questionnaire. The infestation was found in 14 (1.2%) of 1,134 children; 9 (0.8%) with pediculosis capitis and 5 (0.4%) with scabies. We found that infestations were more frequent in children with mothers whose education levels were low. This indicates the necessity of an improvement in the economic and sociocultural status of the community and the promotion of hygiene concepts and practices in order to improve health of preschool age children.
Vinegar folklore is as colorful as it is practical. Legend states that a courtier in Babylonia (c. 5000 BC) "discovered" wine, formed from unattended grape juice, leading to the eventual discovery of vinegar and its use as a food preservative. Hippocrates (c. 420 BC) used vinegar medicinally to manage wounds. Hannibal of Carthage (c. 200 BC), the great military leader and strategist, used vinegar to dissolve boulders that blocked his army's path. Cleopatra (c. 50 BC) dissolved precious pearls in vinegar and offered her love potion to Anthony. Sung Tse, the 10th century creator of forensic medicine, advocated hand washing with sulfur and vinegar to avoid infection during autopsies. Based on the writings of US medical practitioners dating to the late 18th century, many ailments, from dropsy to poison ivy, croup, and stomachache, were treated with vinegar, and, before the production and marketing of hypoglycemic agents, vinegar "teas" were commonly consumed by diabetics to help manage their chronic aliment. This review examines the scientific evidence for medicinal uses of vinegar, focusing particularly on the recent investigations supporting vinegar's role as an antiglycemic agent. Epidemiologic studies and clinical trials were identified by a MEDLINE title/abstract search with the following search terms: vinegar, glucose; vinegar, cancer; or vinegar, infection. All relevant randomized or case-control trials were included in this review.
The timing of head lice maturation most favorable to their survival in the presence of anti-lice agents is the maximum time as an ovum (12 days) and the shortest possible time of maturing from newly hatched nymph to egg-laying adult (8.5 days). Pediculicides that are not reliably ovicidal (pyrethroids and lindane) require 2 to 3 treatment cycles to eradicate lice. Ovicidal therapies (malathion) require 1 to 2 treatments. Treatment with an agent to which there is genetic resistance is unproductive. In the United States, lice have become increasingly resistant to pyrethroids and lindane but not to malathion. Treatment with malathion has favorable efficacy and safety profiles and enables the immediate, safe return to school. Nit combing can be performed adjunctively. No-nit policies should be rendered obsolete.
This study investigated the potential for head lice transmission in swimming pools using an in vitro experiment and a field trial. In the former study, head lice were submerged for 20 min in aqueous solutions at 25 +/- 1 degrees C: deionized water, sea water, salt solutions (30, 60, 120 and 240 g/l), and chlorinated water (0.2, 2 and 5 mg/l). In all trials, lice located on cut hairs became immobile and did not respond to physical prodding. After entering stasis, no movement was observed until after rescue from submersion and a brief recovery period (0-1 min). Upon recovery, all lice fed and no mortality was observed within the next 4 h. In the field trial, four naturally infected individuals swam in a chlorinated pool for 30 min. No loss of lice or head to head transfer was observed. These results indicated that although head lice survive immersion, head lice transmission is unlikely to occur via the water of swimming pools.