Benefits

We found one systematic review (search date 1997) that examined four trials. In each case a single application of treatment was given unless stated otherwise. One study (150 adults and children) compared 5% permethrin cream with 10% crotamiton cream (a non-insecticide) and 1% lindane lotion.8 It used clinical features as the measure of success. The results showed that permethrin was slightly, but not significantly, more likely to cure (49/50 (98%) people with permethrin versus 44/50 (88%) with crotamiton; relative risk (RR) 1-11, 95% confidence intervals (CI) 1-0-1-2). The same study also found permethrin to be significantly more effective than lindane: permethri n cured 49/50 (98% ) whereas lindane cured only 12/50 (24%) people (RR 4-08: CI 2-5-6-7).8 A single randomised controlled trial (RCT) comparing 5% permethrin cream with 10% crotamiton cream evaluated cure by elimination of parasites.9 It found permethrin to be more effective after 14 and 28 days. After 14 days 33/47 (70%) of people in the permethrin group and 41/47 (87%) in the crotamiton group still had lesions. At this point 10 people in the crotamiton group were withdrawn from the study because their infestation was exacerbated. However, after 28 days 42/47 (89%) people in the permethrin group were free from parasites compared with 28/47 (60%) in the crotamiton group (RR 1-5, CI 1-2-1-9).9 This study also recorded patients' subjective reports on the persistence of pruritus, which was found to be closely related to effectiveness of the treatments.

Two trials compared the effect of 5% permethrin cream with that of 1% lindane lotion. A small study (46 people) found fewer people improved 14 days after using permethrin (13/23 (57%) versus lindane 20/23 (87%); P<0-02), but a significantly better rate of cure, by parasitological examination, for permethrin at 28 days (21/23 versus 15/23; P<0-025, RR 1-4, CI 1-0-1-9).10 A larger trial (467 people) did not identify parasites but recorded a significant decrease in the number of lesions persisting in both groups after 14 ± 3 days. At 28 ± 7 days success rates were 181/199 (91%) after using 5% permethrin cream, compared with 176/205 (86%) after using 1% lindane lotion (P = 0-18, RR 1-06, CI 0-9-1-1).11 At final assessment, significantly fewer of the permethrin group (27/194 (14%)) had persistent itch compared with 49/197 (25%) of the lindane group (P= 0-007).11

The systematic review identified no RCTs comparing 0-5% malathion, in either aqueous or alcohol vehicles, with other treatments. Case series and one quasi-randomised trial suggest that it is effective, with a cure rate of over 80% at 4 weeks.12-14

Was this article helpful?

0 0
Natural Treatments For Psoriasis

Natural Treatments For Psoriasis

Do You Suffer From the Itching and Scaling of Psoriasis? Or the Chronic Agony of Psoriatic Arthritis? If so you are not ALONE! A whopping three percent of the world’s populations suffer from either condition! An incredible 56 million working hours are lost every year by psoriasis sufferers according to the National Psoriasis Foundation.

Get My Free Ebook


Post a comment