Efficacy and safety of petroleum jelly versus permethrin 1% shampoo in the treatment of Prediculosis capitis: An assessor-blinded, randomized controlled trial

ABSTRACT

BACKGROUND: The high rates of infestation, treatment failures and treatment costs have created the search for new therapies againts head lice. OBJECTIVE: We compared the efficacy and safety of scalp occlusion with petroleum jelly (PJ) versus permethrin 1% shampoo against Pediculus humanus capitis among school-aged children METHOD: Seventy-seven children were diagnosed with Pediculosis capitis. Thirty-eight subjects did eight-hour scalp occlusion with PJ, and 39 used permethrin shampoo, both followed by nit combing. Treatments were applied once weekly for three consecutive weeks. Patients were assessed at weeks 1,2,3 and 11. The primary outcome was the proportion of cured subjects and change in quality of life (QOL) scores om week 3 of follow-up. Cure was defined as the absence of variable lice on the hair/scalp or nits on the hair shaft attached within one centimeter from the scalp on visual examination.Secondary outcomes were relapse rate at week 11 ,cosmetic acceptability and adverse events. Effects on QOL were measured using the Dermatology Life Quality Index at baseline and at the end of the third week of treatment. RESULTS: At Week 3, cure achieved in 47% (18/38) in PJ group 52% (17/33) in permethrin group (RRR 6.7%, 95% Cl: -40.4% to 38%). Relapse rate in the 12th week were 44% (8/18) and 58% (10/17), respectively (p=0.486, Fisher's test ). The differences in treatment effects were not statistically significant. CONCLUSION: Petroleum jelly scalp occlusion was comparable in cure rates to permethrin. PJ can be a safe, affordable alternative to permethrin as a pediculicide.