Table 3 Topical insecticides and/or medications used in the management of head louse infestation

Permethrin

Synthetic pyrethroid

Inhibits sodium ion influx

Infants (> 2 months) and adults

20–30% eggs remained

Irritation and allergy

[16, 132, 134]

Piperonyl butoxide

Benzodioxoles

Inhibits the metabolism of pyrethrin and increases its persistence and effectiveness against lice

Children (> 2 years) and adults

78–83% (combined with permethrin)

Dermatological symptoms

[16, 132, 134]

Dimethicone

Polydimethylsiloxane

Physical action

Children (> 1 year) and adults

 > 80% (for pyrethroid-resistant)

Dermatological symptoms

[135,136,137]

Xeglyze

Abametapir

Inhibits metalloproteinase

Infants (> 6 months) and adults

Prevented 100% of eggs from hatching

Scalp erythema, rash and burning sensation

[102]

Lotilaner

Isoxazoline

Inhibitsγ-aminobutyric acid-gated chloride channels

School children and older

100% death rate for adult lice with 10 and 100 μmol/L after 3 h exposure

Dermatological symptoms

[138]

Malathion (0.5%)

Organophosphate

Inhibits cholinesterase and acute toxicity

Children (> 6 years)

82–100%

Scalp dryness, irritation, dandruff

[16, 103, 134, 139,140,141]

Spinosad

Aminoglycosides

Alters function of acetylcholine and GABA-gated ion channels

Children (> 4 years)

68–87%

Breathing problems

[6, 142]

Ivermectin 5%

Macrocyclic lactone

Activates glutamate-gated chloride channels in nerve and muscle cells

Children (> 6 months) and adults

74%

Eye irritation and skin-burning sensation

[104, 143, 144]

Oral ivermectin

Macrocyclic lactone

Activates glutamate-gated chloride channels in nerve and muscle cells

Children aged > 5 years and/or weighing > 15 kg and adults

77–95%

Impetigo, nausea or vomiting, gastroenteritis, and convulsion

[141, 145, 146]

Benzyl alcohol 5%

Aromatic alcohol

Closing respiratory spiracles and suffocation

Infants (> 6 months) and adults

75–76%

Breathing problems

[16, 134, 143]