Efficacy and safety of 1% and 5% permethrin lotion as treatment for pediculosis capitis in children: A double blind randomized controlled study

Authors

  • Githa Rahmayunita Faculty of Medicine Universitas Indonesia
  • Lidya Kurnia Pertiwi Faculty of Medicine Universitas Indonesia
  • Purwantyastuti Ascobat Faculty of Medicine Universitas Indonesia
  • Sandra Widaty Faculty of Medicine Universitas Indonesia

Abstract

Background Pediculosis capitis (PC) is a community disease caused by Pediculus humanus capitis, which commonly affects children aged 3–11 years. One percent permethrin is the drug of choice for treating PC, but resistance has been reported in many countries, thus 5% permethrin has been recommended as substitute with satisfactory results in such cases. This study aims to compare effectivity and safety of 1% permethrin lotion (PL1) and 5% permethrin lotion (PL5) as treatment for PC. Methods A double-blind randomized controlled trial was performed in a female boarding school in Indonesia. The treatment was applied twice with a seven-day interval and response to treatment was evaluated on days 7 and 14. Pediculosis capitis was considered cured when no live louse was detected upon evaluation. Results A total of 47 subjects aged 11-15 years completed the study. On days 7 and 14, 15 (62.5%) and 23 (95.8%) subjects were cured in PL1 group, respectively; while 15 (65.2%) and 22 (95.7%) subjects were cured in PL5 group, respectively (p = 1.000). Ten minutes after application on day 0, 3 and 2 subjects who received PL1 and PL5 respectively reported burning sensation (p = 0.527). Also, 1 and 2 subjects reported erythema respectively (p = 0.467). Conclusion In this study, we found that PL1 applied twice with 1-week interval is as effective as PL5 for the treatment of PC in children. Both PL1 and PL5 are safe for the side effects were mild and not different significantly.   Keywords: pediculosis capitis, 1% and 5% permethrin, efficacy, safety, children  

Author Biographies

Githa Rahmayunita, Faculty of Medicine Universitas Indonesia

Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Central General Hospital Jalan Diponegoro no. 71, Jakarta 10430, Indonesia

Lidya Kurnia Pertiwi, Faculty of Medicine Universitas Indonesia

Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Central General Hospital Jalan Diponegoro no. 71, Jakarta 10430, Indonesia

Purwantyastuti Ascobat, Faculty of Medicine Universitas Indonesia

Department of Clinical Pharmacology, Faculty of Medicine Universitas Indonesia, Jalan Salemba Raya no.6, Jakarta 10430, Indonesia

Sandra Widaty, Faculty of Medicine Universitas Indonesia

Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Central General Hospital Jalan Diponegoro no. 71, Jakarta 10430, Indonesia

References

Centers for Disease Control and Prevention. Head lice. Centers for Disease Control and Prevention. Published [date unknown]. Updated [15 October 2019]. Accessed [20 August 2020]. https://www.cdc.gov/parasites/lice/head/index.html

Hapsari RR. Pediculosis capitis in female students’ life at pondok pesantren PPAI an-nahdliyah kabupaten Malang. Media Gizi Kesmas. 2021;10(1):24–31.

Akhmad MA, Menaldi SL. The prevalence of pediculosis capitis and the association between the level of infestation and the characteristics of female students in X boarding school, East Jakarta. Faculty of Medicine Universitas Indonesia; 2012.

Liao CW, Cheng PC, Chuang TW, et al. Prevalence of pediculus capitis in schoolchildren in Battambang, Cambodia. J Microbiol Immunol Infect. 2019;52(4):585-91.

Available from: https://www.sciencedirect.com/science/article/pii/S1684118217302293

Frankowski BL, Bocchini JA. Head lice. Pediatr. 2010;126(2):392–403.

Rassami W, Soowera M. Epidemiology of pediculosis capitis among school children in the eastern area of Bangkok, Thailand. Asian Pac J Trop Biomed. 2012;2:901–4.

Handoko RP. Pedikulosis. In: Menaldi SL, Bramono K, Indriatmi W, editors. Ilmu penyakit kulit dan kelamin. 7th ed. Jakarta: Badan Penerbit Fakultas Kedokteran Universitas Indonesia; 2014. p. 134–5.

Paller AS, Mancini AJ. Infestations, bites, and stings. In: Paller AS, Mancini AJ, editors. Hurwitz clinical pediatric dermatology: a textbook of skin disorder of childhood and adolescence. 4th ed. Canada: Elsevier; 2016. p. 428–47.

Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia. Pedikulosis kapitis. In: Siswati AS, Rosita C, Triwahyudi D, et al., editors. Panduan praktik klinis bagi dokter spesialis dermatologi dan venereologi Indonesia. Jakarta: Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia; 2021. p. 199–203.

Verma P, Namdeo C. Treatment of pediculosis capitis. Indian J Dermatol. 2015;60:238–47.

Devore C, Schutze G. Head lice. Pediatr. 2015;135(5):e1355–65.

Available from: https://doi.org/10.1542/peds.2015-2696

Yoon KS, Lee SH, Marshall JC, Taplin D. Permetrin-Resistant Human Head Lice Pediculus capitis, and Their Treatment. Arch Dermatol. 2003;139(8):994-1000.

Lee SH, Gao JR, Yoon KS, et al. Sodium channel mutations associated with knockdown resistance in the human head louse, Pediculus capitis (De Geer). Pestic Biochem Physiol. 2003;75(3):79–91.

Available from: https://www.sciencedirect.com/science/article/pii/S004835750300018X

Pollack RJ, Kiszewski A, Armstrong P, et al. Differential Permethrin Susceptibility of Head Lice Sampled in the United States and Borneo. Arch Pediatr Adolesc Med. 1999;153(9):969–73.

Available from: https://doi.org/10.1001/archpedi.153.9.969

Novianto E, Ilhamsyah Y, Ramadhiani M, Menaldi S. Efektivitas losio permetrin 5% sebagai pengganti losio heksaklorosikloheksan 0,5% pada pengobatan pedikulosis kapitis. Media Dermato-Venereologica Indonesiana. 2017;4(4):159–64.

Meinking T. Infestations. In: Schachner L, Hansen R, Happle R, Krafchick B, Lucky A, editor, editors. Pediatric Dermatology. 3rd ed. Mosby; 2003. p. 1141–80.

Subahar R, Susanto L, Aidilla R, et al. In vitro experiments of pediculus humanus capitis (Phthiraptera: Pediculidae) resistance to permethrin and 6-paradol in East Jakarta: detoxification enzyme activity and electron microscopic changes in lice. Vet World. 2021;14(11):3065–75.

Bouvresse S, Berdjane Z, Durand R, et al. Permethrin and malathion resistance in head lice: Results of ex vivo and molecular assays. J Am Acad Dermatol. 2012;67(6):1143–50.

Available from: https://www.sciencedirect.com/science/article/pii/S0190962212004343

Meinking TL, Serrano L, Hard B, et al. Comparative In Vitro Pediculicidal Efficacy of Treatments in a Resistant Head Lice Population in the United States. Arch Dermatol. 2002;138(2):220–4.

Available from: https://doi.org/10.1001/archderm.138.2.220.

Downloads

Published

2023-07-02

How to Cite

1.
Rahmayunita G, Pertiwi LK, Ascobat P, Widaty S. Efficacy and safety of 1% and 5% permethrin lotion as treatment for pediculosis capitis in children: A double blind randomized controlled study. J Pak Assoc Dermatol [Internet]. 2023Jul.2 [cited 2024Jul.13];33(2):513-8. Available from: http://www.jpad.com.pk/index.php/jpad/article/view/2141

Issue

Section

Original Articles

Most read articles by the same author(s)