A Conversation for Pediculosis

Is "bug-busting" truly effective?

Post 1

Mikey the Humming Mouse - A3938628 Learn More About the Edited Guide!

This entry claims that:

"The most reliable way to get rid of the bug is the hard way: to systematically, methodically and manually remove all live lice, apparently dead lice and nits."

And goes on to describe the classic technique of "bug-busting," in which children are wet-combed (generally with conditioner or some other substance) to remove lice and nits.

While I am in no way in favor of dumping pesticides on the heads of little kids, I must point out that "bug-busting" as been repeatedly shown to be less effective than pediculocides (pesticides, such as malathion or permethrin, that kill lice and/or nits). A more appropriate phrasing might be "The safest way to get rid of the bug...."

For a recent example, look at this article:

Roberts RJ, Casey D, Morgan DA, Petrovic M. Comparison of wet combing with malathion for treatment of head lice in the UK: a pragmatic randomised controlled trial. Lancet 2000 Aug 12;356(9229):540-4

(the abstract is available online at:
[URL removed by moderator])

The randomised controlled trial found that wet-combing resulted in a 38% cure rate, as opposed to 78% with malathion (and this was in an area with intermediate malathion resistance).

For those that are looking for a more effective solution to pediculosis that doesn't involve pesticides, check out my entry on the RobiComb -- it's been shown to be about as effective as permethrin, which is equally effective as malathion.

just plugging in my 2 cents.

smiley - smiley

Is "bug-busting" truly effective?

Post 2

I'm not really here

Thanks for this, I found that those treatments didn't work. We were still infested the next day.
A couple of goes in the bath always clears my kid up. and a few days in front of the mirror clears me up when I catch them too.

Is "bug-busting" truly effective?

Post 3

Mikey the Humming Mouse - A3938628 Learn More About the Edited Guide!

As a general rule, medical studies don't tell you which treatments will work for any given individual, they tell you which treatments work best *on average*, across a population.

There are families who swear by using vaseline or mayonnaise, or somesuch, because it's worked for them, but in medical trials they are no more effective *on average* than not using anything at all.

This is what doctors are for -- they combine what they know from medical studies, etc., with what they know about the particular patient to figure out the best treatment.

For example, if a family lived in an area with high malathion/permethrin resistance (i.e., London), and the pediatrician knew that the mother and kids could be patient enough to remove the nits/lice thoroughly, the doctor would probably recommend bug-busting/wet-combing as a first-line treatment. Apparently, malathion and permethrin were considerably overused in the UK over the last few decades, and hence British lice have built up resistance -- the drugs are much more effective elsewhere in the world.

smiley - smiley

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