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What's bugging you? An update on the treatment of head lice infestation
  1. Marc Tebruegge1,2,3,
  2. Anastasia Pantazidou2,
  3. Nigel Curtis1,2,3
  1. 1Department of Paediatrics, The University of Melbourne, Parkville, Australia
  2. 2Infectious Diseases Unit, Department of General Medicine, Royal Children's Hospital Melbourne, Parkville, Australia
  3. 3Murdoch Children's Research Institute, Parkville, Australia
  1. Correspondence to Dr Marc Tebruegge, Department of Paediatrics, The University of Melbourne, Royal Children's Hospital Melbourne, Parkville, VIC 3052, Australia; marc.tebruegge{at}


Head lice infestation (pediculosis capitis) is a common problem in paediatric practice. It can cause considerable distress to children and their families and may lead to bullying and social stigmatisation. Therapy with “conventional” topical pediculicides with neurotoxic mode of action—such as malathion, permethrin, phenothrin and carbaryl—is increasingly associated with treatment failure as a result of the emergence of resistance within the parasite population. This review provides an overview of the natural history, clinical symptoms and diagnosis of head lice infestation. It also discusses general management principles and summarises the current data on novel treatment strategies, including wet combing, dimeticone, isopropyl myristate, benzyl alcohol, plant-based compounds and oral medication.

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  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.