Intended for healthcare professionals

Rapid response to:

Clinical Review Evidence based case report

Treatment for head lice

BMJ 1999; 318 doi: (Published 06 February 1999) Cite this as: BMJ 1999;318:385

Rapid Response:

Use of tea tree oil in the treatment of head lice.

Editor - The management of Pediculus humanus capitis, or head lice,
is becoming increasingly contentious due to the reluctance of many people
to use pharmaceutical insecticide preparations. The emergence of
resistance to many over-the-counter and prescription products further
confounds the issue.1, 2 Anecdotal and in vitro evidence suggest that the
essential oil of Melaleuca alternifolia (tea tree oil) and some of its
components may be useful in the treatment of head lice.3-5

Tea tree oil
is an increasingly popular home remedy with a broad spectrum of
antimicrobial activity.6 Preliminary data from usage trials in which
thirty-two schoolchildren in two classes of a remote, rural school
community were provided with tea tree oil shampoo (1% v/v) and conditioner
(2% v/v) for twice weekly use at home (Sunday and Wednesday evenings) are
reported here. Each child's hair was also sprayed with 3% tea tree oil
solution at the beginning of every school day. Not all students in the
classes or school were treated. Informed consent was obtained from
guardians for all participating students. Students were examined twice
weekly (Monday and Thursday mornings) for 4 weeks by a school health nurse
for infestation, defined as the presence of eggs or lice. Students who
missed more than one of the eight evaluations were omitted from data
analysis (n=6). Infestation was recorded after each examination. The
cumulative number of observations of infestation was determined for each

Overall, levels of infestation declined throughout the usage time.
Of the 26 evaluable students, the cumulative scores of infestation for
week one through four were 18, 13, 11 and 6, respectively. The overall
level of infestation fell amongst students after application of the tea
tree oil products suggesting that their use warrants further


1 Brainerd E. From eradication to resistance: Five continuing
concerns about pediculosis. J Sch Health 1998;68:146-50.

2 Dawes M, Hicks NR, Fleminger M, Goldman D, Hamling J, Hicks LJ.
Evidence based case report. Treatment for head lice. BMJ 1999;318:385-6.

3 Veal L. The potential effectiveness of essential oils as a
treatment for headlice, Pediculus humanus capitis. Comp Ther Nurs Mid

4 Weston SE, Burgess I, Williamson EM. Evaluation of essential oils
and some of their component terpenoids as pediculocides for the treatment
of human lice. J Pharm Pharmacol 1997;49(suppl 4):120.

5 Downs AMR, Stafford KA, Coles GC. Monoterpenoids and tetralin as
pediculocides. Acta Derm Venereol 1999;80:69-70

6 Carson CF, Riley TV. Antimicrobial activity of the essential oil
of Melaleuca alternifolia. Lett Appl Microbiol 1993;16:49-55.

D. Chapman

Ord River Tea Tree Oil Pty. Ltd.

Cedar Suite,
Winchester Road,
Hampshire SO24 9EZ

Competing interests: No competing interests

28 November 2000
Francoise Bouic