Control of head lice: past, present and future

Pediculosis capitis is common among children. Rapid and accurate detection is an underlying principle of effective control and the use of a fine-tooth comb in wet, conditioned hair is most sensitive. However, none of the available treatments are fully effective. Of the current pediculicides available over the counter in the UK, those based on malathion are more effective than pyrethroids. Carbaryl is likely to be the most effective insecticide but is only available on prescription. Wet combing with conditioner has proven to be as effective as some over-the-counter lotions for unsupervised use in the home. There are several promising candidates for new insecticidal actives that are likely to be highly effective for a new generation of pediculicides, as well as a variety of unconventional novel treatments.