Meister Laura, Ochsendorf Falk
Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt/Main.
Dtsch Arztebl Int. 2016 Nov 11;113(45):763-772. doi: 10.3238/arztebl.2016.0763.
Conflicting information about the proper treatment of head lice has given rise to uncertainty among patients and treating personnel. For example, the reported efficacy of permethrin fell from 97% in the 1990s to 30% in 2010.
Review of the literature based on a selective search of PubMed.
In Germany, outbreaks of head lice mainly occur among 5- to 13-year-olds returning to school after the summer vacation. Nymphs hatch from eggs after an average of 8 days and become sexually mature lice over the ensuing 9 days. The main route of transmission is direct head-to-head contact; transmission via inanimate objects is of no relevance. Symptoms arise 4-6 weeks after an initial infestation; many affected persons have no symptoms at all. Wet combing is the most sensitive method of establishing the diagnosis and monitoring treatment. Resistance to neurotoxic pediculocidal drugs is increasing around the world. Dimethicones are the treatment of choice, with 97% efficacy. Outbreaks must be managed with the synchronous treatment of all infested persons to break the chain of infestation. If the agent used is not ovicidal, the treatment must be repeated in 8-10 days and sometimes in a further 7 days as well.
Outbreaks of head lice can be successfully terminated by synchronous treatment with ovicidal dimethicones.
关于头虱正确治疗方法的信息相互矛盾，这在患者和治疗人员中引发了不确定性。例如，据报道，氯菊酯的疗效从20世纪90年代的97%降至2010年的30%。
基于对PubMed的选择性检索进行文献综述。
在德国，头虱暴发主要发生在暑假后返校的5至13岁儿童中。若虫平均在8天后从卵中孵化出来，并在随后的9天内发育成性成熟的虱子。主要传播途径是直接的头对头接触；通过无生命物体传播无关紧要。初次感染后4至6周出现症状；许多感染者根本没有症状。湿梳法是确诊和监测治疗最敏感的方法。全球范围内对神经毒性灭虱药物的耐药性正在增加。二甲基硅油是首选治疗药物，疗效达97%。必须对所有感染者进行同步治疗以打破感染链，从而控制疫情暴发。如果使用的药物没有杀卵作用，则必须在8至10天后重复治疗，有时还需在7天后再次治疗。
使用具有杀卵作用的二甲基硅油进行同步治疗可成功控制头虱暴发。
