Clinical trial showing superiority of a coconut and anise spray over permethrin 0.43% lotion for head louse infestation, ISRCTN96469780 - ClearLice

Clinical trial showing superiority of a coconut and anise spray over permethrin 0.43% lotion for head louse infestation, ISRCTN96469780

Topic(s) study pertains to

Coconut Oil, Ineffectiveness of OTC treatment

Place of study

Medical Entomology CentreInsect Research & Development LimitedCambridgeUK

Name of Scientist

  • Ian F. Burgess
  • Elizabeth R. Brunton
  • Nazma A. Burgess


EUR 34.95


Permethrin is the most widely used pediculicide, but evidence of resistance from several countries and anecdotal reports from Germany suggest that permethrin lotion is now less effective. We designed a randomized, controlled, parallel group trial involving 100 participants with active head louse infestation to investigate the activity of a coconut and anise spray and to see whether permethrin lotion is still effective, using two applications of product 9 days apart. The spray was significantly more successful (41/50, 82.0%) cures compared with permethrin (21/50, 42.0%; p < 0.0001, difference 40.0%, 95% confidence interval of 22.5% to 57.5%). Per-protocol success was 83.3% and 44.7%, respectively. Thirty-three people reported irritant reactions following alcohol contact with excoriated skin. We concluded that, although permethrin lotion is still effective for some people, the coconut and anise spray can be a significantly more effective alternative treatment.



  1. 1.
    Burgess IF (1999) Dermatopharmacology of antiparasitics and insect repellents. In: Gabard B, Elsner P, Surber C, Treffel P (eds) Dermatopharmacology of topical preparations. Springer-Verlag, Heidelberg, pp 157–178Google Scholar
  2. 2.
    Burgess IF, Brown CM (1999) Management of insecticide resistance in head lice, Pediculus capitis (Anoplura: Pediculidae). Proceedings of the 3rd International Conference on Control of Urban Pests, Prague, pp 249–253Google Scholar
  3. 3.
    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(11):e1127. doi:10.1371/journal.pone.0001127CrossRefPubMedGoogle Scholar
  4. 4.
    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. Pharm J 280:371–375Google Scholar
  5. 5.
    Downs AMR, Stafford KA, Coles GC (1999) Head lice: prevalence in schoolchildren and insecticide resistance. Parasitol Today 15:1–3. doi:10.1016/S0169-4758(98)01361-1CrossRefPubMedGoogle Scholar
  6. 6.
    Durand R, Millard B, Bouges-Michel C et al (2007) Detection of pyrethroid resistance gene in head lice in schoolchildren from Bobigny, France. J Med Entomol 44:796–798. doi:10.1603/0022-2585(2007)44[796:DOPRGI]2.0.CO;2CrossRefPubMedGoogle Scholar
  7. 7.
    Hemingway J, Miller J, Mumcuoglu KY (1999) Pyrethroid resistance mechanisms in the head louse Pediculus capitis from Israel: implications for control. Med Vet Entomol 13:89–96. doi:10.1046/j.1365-2915.1999.00141.xCrossRefPubMedGoogle Scholar
  8. 8.
    Kristensen M (2005) Identification of sodium channel mutations in human head louse (Anoplura: Pediculidae) from Denmark. J Med Entomol 42:826–829. doi:10.1603/0022-2585(2005)042[0826:IOSCMI]2.0.CO;2CrossRefPubMedGoogle Scholar
  9. 9.
    Mumcuoglu KY, Miller J, Zamir C et al (2002) The in vivo pediculicidal efficacy of a natural remedy. Isr Med Assoc J 4:790–793PubMedGoogle Scholar
  10. 10.
    Oliveira FAS, Speare R, Heukelbach J (2007) High in vitro efficacy of Nyda®L, a pediculicide containing dimeticone. J Eur Acad Dermatol Venereol 21:1325–1329. doi:10.1111/j.1468-3083.2007.02258.xCrossRefPubMedGoogle Scholar
  11. 11.
    Picollo MI, Vassena CV, Casadio AA et al (1998) Laboratory studies of susceptibility and resistance to insecticides in Pediculus capitis (Anoplura; Pediculidae). J Med Entomol 35:814–817PubMedGoogle Scholar
  12. 12.
    Scanni G, Bonifazi E (2005) Efficacy and safety of a new non-pesticide lice removal product. Eur J Pediatr Dermatol 15:49–52Google Scholar
  13. 13.
    Thomas DR, McCarroll L, Roberts R et al (2006) Surveillance of insecticide resistance in head lice using biochemical and molecular methods. Arch Dis Child 91:777–778. doi:10.1136/adc.2005.091280CrossRefPubMedGoogle Scholar
  14. 14.
    Yoon KS, Gao JR, Lee SH et al (2003) Permethrin-resistant human head lice, Pediculus capitis, and their treatment. Arch Dermatol 139:94–1000. doi:10.1001/archderm.139.8.994CrossRefGoogle Scholar
  15. 15.
    Yoon KS, Gao JR, Lee SH et al (2004) Resistance and cross-resistance to insecticides in human head lice from Florida and California. Pestic Biochem Physiol 80:192–201. doi:10.1016/j.pestbp.2004.07.008CrossRefGoogle Scholar

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© Springer-Verlag 2009
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