"Head lice. Dimeticone (or dimethicone) appears superior to traditional treatments (like permethrin or malathion)"
The latest Alberta Tools for Practice1 found that Dimeticone (or dimethicone) appears superior to traditional lice treatments (like permethrin or malathion), getting one more in 3-4 patients lice free with no increased adverse events. Dimeticone is a silicone-based product that suffocates lice and is applied to dry hair, left eight hours, and often repeated after one week.
The doses of Dimethicone ranged from 4% in one study to 92% in another (Dimethicone 5% and 10% is fully funded barrier cream in NZ).When all else fails consider oral co-trimoxazole (Gem from 2015). In one trial it was found that permethrin 1% (note that in NZ the dose is 5%) had a 72% success rate at 4 weeks while permethrin combined with co-trimoxazole had a success rate of 93%2. Remember co-trimoxazole has some serious adverse effects.
Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.