Oral ivermectin for head lice: a comparison with 0.5 \% topical malathion lotion

Background: Reports of treatment failure of head lice have become increasingly common. Oral ivermectin has been proposed as a potential alternative for the treatment of head lice infestation. The aim of this study was to compare the efficacy of oral ivermectin with topical malathion lotion in the treatment of head lice. Patients and methods: Eighty apparently healthy children with head lice infestation were randomly assigned to 2 groups, with 40 patients in each. The first group received oral ivermectin as a single dose of 200 mu g /kg and the second group received single topical application of malathion lotion 0.5 \%. Follow up visits were done at days 8, 15 and 29. A second dose of either drug was given at day 8 in case of treatment failure. Results: After a single dose, complete cure was achieved in 77.5 \% and 87.5 \% of ivermectin and malathion groups respectively. After the second dose for nonresponders, the cure rate increased to 92.5 \% in the ivermectin group and 95 \% in the malathion group. No major adverse effects were observed in either group. Conclusions: Oral ivermectin is a promising effective approach for the treatment of head lice and could be an ideal substitute for conventional pediculicides.