Effectiveness of wet combing compared with 1% permethrin lotion for the treatment of pediculosis capitis

Objective: Pediculus humanus capitis is an ectoparasite that sucks blood from the patient’s scalp. Gamma-hexachlorocyclohexane is an effective treatment but its use has been discontinued because of its neurotoxicity. Although the replacement pediculicide is permethrin, this is not affordable for everyone, and thus the recommended treatment is wet combing. The aim of this study is to evaluate the effectiveness of permethrin compared with wet combing for eliminating pediculosis. Methods: This study was a randomized controlled trial (RCT) conducted in a boarding school in Bogor District; the data were collected in July–August, 2018. Subjects were regarded as infested if lice were found during examination. Infested subjects were divided into two groups. In the permethrin group, the hair was wetted with permethrin lotion and left for 10 min. Afterwards, a fine-toothed comb was used to remove lice, and then the subjects were instructed to wash their hair with shampoo. On day 14, each subject’s head was reexamined to determine the cure rate. The wet-combing group was treated similarly but using conditioner instead of permethrin. Results: Of 121 subjects, 88.4% were infested with head lice. The cure rate after one week of treatment was 66% in the permethrin group and 63% in the wet-combing group. After a two-week course of treatment, the cure rate increased to 94% in permethrin group and 89% in the wet-combing group. There was no significant difference in cure rate between permethrin and wet combing after a one-(P = 0.740) or two-week (P = 0.507) course of treatment. Conclusion: The prevalence of pediculosis capitis in a boarding school in Bogor District was 88.4%. Wet combing treatment was as effective as permethrin for treating pediculosis capitis.