Effective head lice treatments battling infestations, with a magnifying glass hovering above.

Head Lice Treatment: Why Cocamide DEA Lotion Falls Short

Nico Varela in Health & Wellness August 2025 • 4 min read.

"A Deep Dive into a Failed Clinical Trial and the Ongoing Battle Against Head Lice"

Head lice. The mere mention of these tiny, tenacious insects can send shivers down the spines of parents everywhere. These unwelcome guests are a common nuisance, particularly among school-aged children. While numerous treatments promise quick eradication, the reality is often a frustrating cycle of application, combing, and re-infestation.

In the late 1990s, rising insecticide resistance prompted a search for alternative treatments. One such alternative was cocamide diethanolamine (DEA), a surfactant-based lotion. The hope was that this compound, known for its cleansing properties, could effectively eliminate head lice infestations. But did it live up to the hype? A detailed clinical trial sought to answer that question, and the results weren't exactly promising.

This article delves into the findings of a rigorous laboratory and clinical study investigating the efficacy of cocamide DEA lotion against head lice. We'll break down the study's methodology, results, and conclusions, providing a clear understanding of why this particular treatment didn't deliver the desired outcomes. More importantly, we'll explore what does work, offering evidence-based strategies for managing and eliminating head lice infestations effectively.

The Cocamide DEA Experiment: A Closer Look

Effective head lice treatments battling infestations, with a magnifying glass hovering above.

The study, conducted by Ian F. Burgess, Elizabeth R. Brunton, and Christine M. Brown, involved both laboratory (in vitro) testing and community-based clinical trials. The initial lab tests assessed the lotion's impact on laboratory-reared body lice and their eggs. This was followed by two randomized, controlled clinical studies involving children and adults with confirmed head lice infestations.

The clinical trials compared different treatment regimens:

Study 1: Compared a single application of 10% cocamide DEA lotion for 60 minutes followed by shampooing, against a single application of 1% permethrin creme rinse.
Study 2: Compared two regimens using 10% cocamide DEA lotion concentrated by hair drying: a single overnight application versus two applications, seven days apart, each lasting two hours.

The researchers meticulously tracked the success rates of each treatment, noting any adverse events reported by participants. The results, unfortunately, revealed a significant shortcoming in the efficacy of cocamide DEA lotion.

Effective Strategies for Combating Head Lice

While the cocamide DEA lotion study yielded disappointing results, it's important to remember that effective head lice treatments do exist. A multi-pronged approach, combining thorough combing with evidence-based treatments, is often the most successful strategy. Consult with your doctor or pharmacist to determine the best course of action for your family. With persistence and the right approach, you can win the battle against head lice and restore peace of mind.

About this Article -

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Everything You Need To Know

Why was cocamide DEA lotion considered as a potential treatment for head lice infestations?

In the late 1990s, increased insecticide resistance led to the exploration of alternative treatments for head lice. Cocamide diethanolamine (DEA), a surfactant-based lotion known for its cleansing properties, was investigated as a potential solution. The hope was that it could effectively eliminate head lice infestations, offering a new approach in combating these persistent pests. However, it's important to note that while cocamide DEA was explored, the clinical trials revealed its limited efficacy, highlighting the need for alternative and more effective treatment strategies.

What were the key findings of the clinical trials that tested the effectiveness of cocamide DEA lotion against head lice?

The clinical trials, conducted by Ian F. Burgess, Elizabeth R. Brunton, and Christine M. Brown, revealed that cocamide diethanolamine (DEA) lotion was not particularly effective in treating head lice infestations. Study 1 compared a single application of 10% cocamide DEA lotion against 1% permethrin creme rinse, while Study 2 tested different regimens of 10% cocamide DEA lotion concentrated by hair drying. The results indicated a significant shortcoming in the efficacy of cocamide DEA lotion, meaning it didn't perform as well as hoped in eliminating head lice compared to other treatments like permethrin.

What alternative treatment strategies are recommended given the limited effectiveness of cocamide DEA lotion?

Given the disappointing results of cocamide diethanolamine (DEA) lotion in treating head lice, a multi-pronged approach is recommended. This includes thorough combing to physically remove lice and nits, combined with evidence-based treatments. Consulting with a doctor or pharmacist is crucial to determine the best course of action. Other treatments, such as permethrin creme rinse, are considered effective and should be discussed with a medical professional. Furthermore, understanding the specific needs of the individual and the severity of the infestation is essential in choosing the most appropriate treatment strategy.

Can you elaborate on the methodology used in the clinical trials that assessed cocamide DEA lotion?

The clinical trials evaluating cocamide diethanolamine (DEA) lotion involved a rigorous approach. Initially, laboratory (in vitro) testing assessed the lotion's impact on laboratory-reared body lice and their eggs. Following the lab tests, two randomized, controlled clinical studies were conducted with children and adults who had confirmed head lice infestations. These trials compared different treatment regimens. Study 1 compared a single 60-minute application of 10% cocamide DEA lotion followed by shampooing against a single application of 1% permethrin creme rinse. Study 2 compared two regimens of 10% cocamide DEA lotion concentrated by hair drying: a single overnight application versus two applications seven days apart, each lasting two hours. Researchers meticulously tracked the success rates of each treatment and noted any adverse events reported by participants.

Since cocamide DEA lotion proved ineffective, what are the potential implications of relying on treatments that lack strong clinical evidence?

Relying on treatments lacking strong clinical evidence, like cocamide diethanolamine (DEA) lotion, can lead to several negative implications. Firstly, it can result in prolonged infestations, causing discomfort and potential secondary skin infections from scratching. Secondly, the continued use of ineffective treatments may contribute to increased resistance in head lice populations to available medications. Additionally, it can create unnecessary stress and frustration for families dealing with the infestation. Finally, it delays the implementation of evidence-based strategies, such as thorough combing and effective medications like permethrin, which are proven to combat head lice effectively. It is important to prioritize treatments supported by robust clinical trials to ensure successful eradication and prevent further complications.