Dimeticone-Based Pediculicides: A Physical Approach to Eradicate Head Lice

Resistance of head lice to insecticides with a neurotoxic mode of action, such as permethrin and malathion, is increasing in incidence and geographic extent. As a consequence, physically acting pediculicidal products have emerged. Dimeticones are synthetic silicone oils of low surface tension and can therefore coat most surfaces, thus also killing head lice (Pediculus humanus capitis) by physical means. Considering this mode of action, the development of head lice resistance in the future is very unlikely. In this review, ex vivo and clinical evidence on the efficacy of dimeticones against head lice is presented. Besides the high adulticidal and excellent ovicidal ex vivo efficacy, clinical efficacy of high concentrated dimeticone has been shown. We conclude that dimeticone-based products are a safe and effective option for those patients who prefer not to use pediculicides with a neurotoxic mode of action, especially in areas where resistances of head lice against permethrin and malathion-based products have been reported, or are suspected.