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

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.