Single application of ivermectin lotion helps get rid of head liceBMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e7472 (Published 06 November 2012) Cite this as: BMJ 2012;345:e7472
Oral ivermectin is often used to treat infection with roundworms, but its topical preparation might also help combat head lice. New preparations are needed for this condition because of increased resistance to existing first line agents, such as permethrin and pyrethrins.
Two trials tested home application of 0.5% ivermectin lotion against vehicle only in nearly 300 children aged 6 months or older. All children were the youngest affected household members (three or more head lice) and were considered index patients. In addition, all household members were checked for head lice, and those with three or more were also enrolled.
Both the active and control lotion were applied once, on dry hair, left for 10 minutes, and rinsed with water. Nit combing wasn’t allowed. The next day, 94.9% (131/138) of children who had received the active lotion were free of lice, compared with 31.3% (46/147) who received the control lotion. A week and two weeks later, these figures were 85.2% versus 20.8% and 73.8% versus 17.6%, respectively.
There were no serious adverse events. Pruritus, excoriation, and erythema were more common with the control lotion than with ivermectin (1.5% v 0.8%, 1.2% v 0.3%, and 1.2% v 0.5%, respectively). It was thought that only eye irritation and skin burning sensations were related to the study drug, but these were rare.
The authors of a linked editorial (p 1750) write that ivermectin could be the last choice in treating head lice, after all the other options had failed.
Cite this as: BMJ 2012;345:e7472