Combing wet hair with conditioner and a fine-tooth comb is four times more effective at curing pediculosis than water-based, over-the-counter pediculicide shampoos, Nigel Hill, Ph.D., and colleagues reported.
The study contradicts others that have found pediculicides more effective than wet combing—possibly because the lice examined in the new study appeared to have developed resistance to permethrin, one of the most common active ingredients in the shampoos, said Dr. Hill, head science officer of the London School of Hygiene and Tropical Medicine, and his associates (BMJ 2005;331:384–7).
The researchers randomized 133 children aged 2–15 years with head lice to either the “Bug Buster” wet-combing kit or to a water-based, over-the-counter pediculicide containing either malathion or permethrin.
The Bug Buster kit, developed by the United Kingdom charity organization Community Hygiene Concern, includes a fine-tooth comb and conditioner. Treatment consists of four sequential combings of wet, conditioned hair with 3 days between each combing. The cure rates were 17% for malathion shampoo, 10% for permethrin, and 57% for the Bug Buster kit.
Several factors could account for the difference, the investigators said. The most recent Bug Buster kit has an improved comb. Also, only one dose of the pediculicide shampoo was used, while many physicians tell their patients to use two doses.