Purpose of review: Following the increase in prevalence of head lice during the 1990s, research interest in human louse infestation is now greater than at any time since World War I. Problems with treatment, resulting from the selection of populations of lice resistant to insecticides by overuse of some types of product, have triggered an interest in the development of novel therapeutic agents.
Recent findings: This review first discusses the background to treatment options, basic diagnostic criteria for deciding whether treatment is required and the efficiency of different techniques. Following recent evidence for resistance to insecticides, alternative therapies are examined, including plant-derived essential and fixed oils that are seen by consumers as safer alternatives to pesticides, physically acting preparations and combing options.
Summary: I have found that most diagnostic methods lack evidence of efficacy or effectiveness and the evidence for efficacy of several 'popular' options for alternatives to insecticides in treatment is either scant or missing. Claims related to the activity of some products need to be examined more deeply to determine whether they are of real value.