The Unani Approach to Pediculosis: Understanding and Treating Lice Infestation

Document Type : Original Article

Authors

1 PG Scholar Department of Kulliyat Tibb, N.I.U.M Kottigepalya, Bangalore, India

2 Jild wa Tazeeniyat, N.I.U.M Kottigepalya, Bangalore, India

Abstract

Pediculosis, a parasitic condition caused by distinct lice species, remains a significant public health concern due to its widespread occurrence, particularly among children and adolescents, and in conditions of overcrowding and poor hygiene. This article examines pediculosis from both the Unani and Persian systems of medicine and contemporary medical perspectives, covering its history, life cycle, etiopathogenesis, risk factors, signs, symptoms, diagnosis, and treatment. This review aims to provide a comprehensive understanding of pediculosis, presenting insights from both Unani/Persian and modern scientific perspectives. It also proposes the potential for integrated or complementary treatment strategies. A comprehensive literature review was conducted, analyzing manuscripts of Unani/Persian medicine and contemporary scientific research to explore the historical context, biology, risk factors, and management strategies of pediculosis. A search was conducted on PubMed, Google Scholar, and Scopus until October 2023, using keywords such as lice, pediculicide, insect, and insecticide alongside the scientific name of each plant. The review highlights the divergence between traditional and modern medical explanations. While the Unani/Persian medicine explains lice infestation based on bodily secretions and environmental factors, contemporary medicine emphasizes lice feeding on blood and the ensuing inflammatory response. Both approaches emphasize the importance of hygiene and environmental conditions for lice infestation. Potential hybrid approaches may offer more comprehensive and effective strategies for managing pediculosis by integrating traditional and modern understandings. Unani/Persian medicine’s emphasis on herbal remedies and lifestyle adjustments, combined with modern pharmacological treatments, presents a promising direction for future research and treatment paradigms.

Highlights

Sabba Saltanat (Google Scholar)

Nadeem Ahmad Shah (Google Scholar)

Keywords


  1. Abdel-Ghaffar, F., et al., 2012. Efficacy of a single treatment of head lice with a neem seed extract: an in vivo and in vitro study on nits and motile stages. Parasitology research, 110, pp. 277–280.
  2. Aghili, A.K.S.S., Rahimi, R., and Shams-Ardekani, M.R., 2009. Makhzan ul-Advia. Tehran: University of Medical Sciences.
  3. AH, J., 2010. Zakheera Khwarzam Shahi. New Delhi: Idara kitab-us-shifa.
  4. Ahmad, I., Ibrar, M., and Ali, N., 2011. Ethnobotanical study of tehsil kabal, swat district, KPK, pakistan. J of Botany, 2011, 1, pp. 1-9.
  5. Al-Akhavaynī, A.B.R. and Matīnī, J., 1965. Hidāyat al-mutaʻallimīn fī al-ṭibb. Mashhad: Chāpkhanah-ʼi Dānishgāh-i Mashhad.
  6. Al-Zanbagi, N.A., and Al-Hashdi, D.F., 2014. Assessment in Vitro of the Pediculicidal Activity of Onion Bulb, Cucumber Fruit and Camel Urine. Available at: https://api.semanticscholar.org/CorpusID:212480660. [Accessed 20 October 2023]
  7. Al-Zayyadi, S.W., 2020. Study of the effectiveness of some raw plants and materials in the treatment of pediculosis in Najaf Province Iraq. Indian J of Forensic Medicine & Toxicology, 14(1), pp. 499–503.
  8. Alzweiri, M., et al., 2011. Ethnopharmacological survey of medicinal herbs in Jordan, the Northern Badia region. J of Ethnopharmacology, 137(1), pp. 27–35.
  9. AMBZ, R., 2005. Kitabul Fakhir Fit Tib. New Delhi: CCRUM.
  10. Arnold, J.D., 2017. Topical Mercurials for the Treatment of Pediculosis. JAMA dermatology, 153(5), pp. 457–457.
  11. Arzani, H.A., 2005. Tib e Akbar. Urdu translation by Hakim Mohammad Hussain. New Delhi: Idara Kitabul Shifa.
  12. Avicenna, 2010. Al Qanoon Fil Tibb. Urdu translation by GH. Kantoori. New delhi: Idara Kitab Ul Shifa.
  13. Bartosik, K., Zając, Z., and Kulisz, J., 2015. Head pediculosis in schoolchildren in the eastern region of the European Union. Annals of Agricultural and Environmental Medicine, 22(4), pp. 599-603.
  14. Benitez, J.M., et al., 2015. Effectiveness of Custard Apple (Annona squamosa) Seed Extract in Treating Pediculosis Capitis. Recoletos Multidisciplinary Research J, 3(2), pp. 99-109.
  15. Bohl, B., et al., 2015. Clinical practice update: pediculosis capitis. Pediatric nursing, 41(5), p. 227.
  16. Boutellis, A., Abi-Rached, L., and Raoult, D., 2014. The origin and distribution of human lice in the world. Infection, Genetics and Evolution, 23, pp. 209–217.
  17. Burgess, I.F., 1995. Human lice and their management. Advances in parasitology, 36, pp. 271–342.
  18. Burns, T., et al., 2008. Rook’s textbook of dermatology. Hoboken, New Jersey, USA: John Wiley & Sons.
  19. Candy, K., et al., 2020. Essential oils as a potential treatment option for pediculosis. Planta Medica, 86(09), pp. 619–630.
  20. Chandrashekar, B., 2018. IADVL textbook of trichology. New Delhi: Jaypee Brothers Medical Publishers Pvt. Ltd.Daryaganj.
  21. Choi, H.-Y., et al., 2010. Efficacy of spray formulations containing binary mixtures of clove and eucalyptus oils against susceptible and pyrethroid/malathion-resistant head lice (Anoplura: Pediculidae). J of medical entomology, 47(3), pp. 387–391.
  22. Clark, J.M., et al., 2013. Human lice: Past, present and future control. Pesticide Biochemistry and Physiology, 106(3), pp. 162–171.
  23. Dagrosa, A.T., and Elston, D.M., 2017. What’s eating you? head lice (Pediculus humanus capitis). Cutis, 100(6), pp. 389–392.
  24. Delario, A., 1950. Minerals in medicine. Rocks & Minerals, 25(11–12), pp. 580–594.
  25. Di Campli, E., et al., 2012. Activity of tea tree oil and nerolidol alone or in combination against Pediculus capitis (head lice) and its eggs. Parasitology research, 111, pp. 1985–1992.
  26. Di Stefani, A., Hofmann-Wellenhof, R., and Zalaudek, I., 2006. Dermoscopy for diagnosis and treatment monitoring of pediculosis capitis. J of the American Academy of Dermatology, 54(5), pp. 909–911.
  27. El Akkad, D.M., et al., 2016. Electron microscopic alterations in Pediculus humanus capitis exposed to some pediculicidal plant extracts. The Korean J of Parasitology, 54(4), p. 527.
  28. El-Bahnasawy, M.M., Abdel, F., and Morsy, T.A., 2012. Human pediculosis: a critical health problem and what about nursing policy. J Egypt Soc Parasitol, 42(3), pp. 541–62.
  29. Elston, D., 1999. What’s eating you? Psocoptera (book lice, psocids). Cutis, 64(5), pp. 307–308.
  30. Elumalai, S., et al., 2016. Comparative study on anti-microbial activities of bark oil extract from cinnamomum cassia and cinnamomum zeylanicum. Biosciences Biotechnology Research Asia, 7(1), pp. 251–258.
  31. Fornaciari, G., et al., 2011. The use of mercury against pediculosis in the Renaissance: the case of Ferdinand II of Aragon, King of Naples, 1467–96. Medical history, 55(1), pp. 109–115.
  32. Ghumare, P., et al., 2014. A review of Pongamia pinnata–an important medicinal plant. Current Research in Pharmaceutical Sciences, 4(2), pp. 44–47.
  33. Gulgun, M., et al., 2013. Pediculosis capitis: prevalence and its associated factors in primary school children living in rural and urban areas in Kayseri, Turkey. Central European J of Public Health, 21(2)., pp. 104–108.
  34. Gupta, R.K., and Gupta, R.C., 2022. Placental toxicity. In: Reproductive and developmental toxicology. 3rd ed. Chapter 68. Available at: https://doi.org/10.1016/B978-0-323-89773-0.00068-0 [Accessed 17 October 2023] Elsevier, pp. 1373–1397.
  35. Gutiérrez, M.M., et al., 2016. The potential application of plant essential oils to control Pediculus humanus capitis (Anoplura: Pediculidae). Parasitology research, 115, pp. 633–641.
  36. Hossain, S., Mahmud, S., and Rahmatullah, M., 2012. Inter-country exchanges of folk medicinal practices: a case study of a folk medicinal practitioner of Savar in Dhaka district, Bangladesh. Am-Eur J Sustain Agr, 6, pp. 281–91.
  37. Hubal, I., 2005. Kitabul Mukhtarat Fil Tib. Translated from Urdu. Vol. I. New Delhi: CCRUM.
  38. Intaranongpai, J., Chavasiri, W., and Gritsanapan, W., 2006. Anti-head lice effect of Annona squamosa seeds. Southeast Asian J of Tropical Medicine and Public Health, 37(3), p. 532.
  39. Izzah, I.N.L., et al., 2022. The Potential of Natural Ingredients as Anti Pediculosis capitis: A Narrative Review. Archives of The Medicine and Case Reports, 3(4), pp. 300–303.
  40. Jadhav, V., Kore, A., and Kadam, V., 2007. In-vitro pediculicidal activity of Hedychium spicatum essential oil. Fitoterapia, 78(7–8), pp. 470–473.
  41. Kabeeruddin, M., 2007. Makhzanul mufradat. New Delhi: Idara Kitabus Shifa.
  42. Kamalinejad, M., et al., 2019. Investigating the Efficacy of Sumac Topical Solution Against Permethrin-resistant Human Head Lice. Int J of Medical Toxicology and Forensic Medicine, 9(3), pp. 117–124.
  43. Kartman, L., 1949. Preliminary observations on the relation of nutrition to pediculosis of rats and chickens. The J of Parasitology, 35(4), pp. 367–374.
  44. Khan, M.A., 2011. Akseer Azam (Al Akseer). New Delhi: Idara kitabus Shifa, pp. 832–852.
  45. Khani, A., and Basavand, F., 2012. Chemical composition and insecticidal activity of myrtle (Myrtus communis L.) essential oil against two stored-product pests. J of Medicinal plants and By-product, 1(2), pp. 83–89.
  46. Khare, C.P., 2008. Indian medicinal plants: an illustrated dictionary. New York: Springer Science & Business Media.
  47. Khazain-ul-Advia, G.N., and Delhi, N., 2011. Idara Kitab-us-Shifa. New Delhi: Idara KIba Ul shifa, p. 293.
  48. Khokhar, A., 2002. A study of pediculosis capitis among primary school children in Delhi. Indian J of Medical Sciences, 56(9), pp. 449–452.
  49. Kittler, R., Kayser, M., and Stoneking, M., 2003. Molecular evolution of Pediculus humanus and the origin of clothing. Current Biology, 13(16), pp. 1414–1417.
  50. Ko, C.J., and Elston, D.M., 2004. Pediculosis. J of the American Academy of Dermatology, 50(1), pp. 1–12.
  51. Kristinawati, E., Zaetun, S., and Srigede, L., 2018. Effectiveness of the combination of lime leaf filtrate (Citrus aurantifolia) and fragrant pandan leaf (Pandanus amaryllifolius) as a natural insecticide to kill head lice (Pediculus humanus capitis). Media Bina Ilmiah, 1(1), pp. 12–8.
  52. Kuder, R.C., 1947. Larkspurs, delphiniums, and chemistry. J of Chemical Education, 24(9), p. 418.
  53. Kumar, A., et al., 2012. Antiparasitic efficacy of piperine against Argulus spp. on Carassius auratus (Linn. 1758): in vitro and in vivo study. Parasitology research, 111, pp. 2071–2076.
  54. Kumari, V., et al., 2023. Modern role of essential oils in drug discovery and medicinal products. In: New Horizons in Natural Compound Research. Chapter 18. Elsevier, pp. 351–360.
  55. Lam, M., Crutchfield, C.E., and Lewis, E.J., 1997. Hair casts: a case of pseudonits. Cutis, 60(5), pp. 251–252.
  56. Lawless, J., 1992. The Encyclopaedia of Essential Oils. United Kingdom: Harper Thorsons.
  57. Lee, P., 2015. Family matters: Head lice and worms: Ditch the creepy critters. PS Post Script. Melbourne, Vic.: Australian Pharmaceutical Publishing Company, pp. 16–18. Available at: https://search.informit.org/doi/10.3316/informit.448537014543121. [Accessed 20 October 2023]
  58. Madke, B., and Khopkar, U., 2012. Pediculosis capitis: an update. Indian J of Dermatology, Venereology and Leprology, 78, p. 429.
  59. Majeed, M., et al., 2007. Neem oil limonoids: Product Overview. Sabinsa Corporation, pp. 1–8. Available at: https://beta.rodpub.com/public/uploads/80789neem-oil-limonoids.pdf [Accessed 17 October 2023]
  60. Majusi, A., 1889. Kamil us Sana’ah. Urdu translation by Gh. Kantoori. New Delhi: Idarah Kitab al shifa.
  61. Malviya, R., et al., 2020. Formulation of Herbal Shampoo against Head Louse (De Geer). The Open Biology J, 8(1), pp. 74-80.
  62. Marimuthu, S., et al., 2012. Lousicidal activity of synthesized silver nanoparticles using Lawsonia inermis leaf aqueous extract against Pediculus humanus capitis and Bovicola ovis. Parasitology Research, 111, pp. 2023–2033.
  63. Mazandarani, M., et al., 2012. Autecology, phytochemical and antioxidant activity of Peganum harmala L. seed extract in North of Iran (Tash Mountains). J of Medicinal plants and By-product, 1(2), pp. 151–156.
  64. Mehlhorn, H., et al., 2011. Ovicidal effects of a neem seed extract preparation on eggs of body and head lice. Parasitology Research, 109, pp. 1299–1302.
  65. Milhau, G., et al., 1997. In vitro antimalarial activity of eight essential oils. J of Essential Oil Research, 9(3), pp. 329–333.
  66. Miraj, S., 2016. A review study of therapeutic effects of Peganum harmala. Seeds, 4, p. 8.
  67. Morsy, T.A., et al., 2000. Evaluation of the in-vitro pediculicidal action of four known insecticides and three medicinal plant extracts. J of the Egyptian Society of Parasitology, 30(3), pp. 699–708.
  68. Muniyandi, S.K., et al., 2013. Evaluation of Costus speciosus Koen aqueous extract for larvicidal activity. Der Pharmacia Lettre, 5(4), pp. 283–285.
  69. Nadkarni, A., 1954. Nadkarni’s Indian Materia Medica. Jaipur: Popular Book Depot.
  70. Nutanson, I., Steen, C., and Schwartz, R., 2007. Pediculosis corporis: an ancient itch. Acta dermatovenerologica Croatica, 15(1), pp. 0–0.
  71. Oladimeji, F., et al., 2000. Pediculocidal and scabicidal properties of Lippia multiflora essential oil. J of Ethnopharmacology, 72(1–2), pp. 305–311.
  72. Patel, J.D., and Kumar, V., 2008. Annona squamosa L.: phytochemical analysis and antimicrobial screening. J of Pharmacy Research, 1(1), pp. 34–38.
  73. Perotti, M.A., et al., 2004. The sex ratio distortion in the human head louse is conserved over time. BMC genetics, 5(1), pp. 1–13.
  74. Putriana, N.A., et al., 2019. In vitro effectiveness of neem oil (Azadirachta Indica A. Juss) shampoo as anti head lice (Pediculus humanus capitis). Pharmacology and Clinical Pharmacy Research, 4(3), pp. 76–80.
  75. RA, K., 2010. Tarjuma Sharah Asbab. New Delhi: CCRUM.
  76. Raja, R.R., and Sreenivasulu, M., 2016. Pongamia Pinnata—Phytotherapeutic review. World J Pharm Res, 5(4), pp. 505–511.
  77. Razi, Z., 2008. Kitab al-Hawi. New Delhi: Central Council for Research in Unani Medicine.
  78. Roqaiya, M., and Begum, W., 2015. A review on medicinal aspect of alum in Unani medicine and scientific studies. World J Pharm Res, 4(6), pp. 929–940.
  79. Rossini, C., Castillo, L., and González, A., 2008. Plant extracts and their components as potential control agents against human head lice. Phytochemistry Reviews, 7, pp. 51–63.
  80. Saha, R., 2011. Pharmacognosy and pharmacology of Annona squamosa. Int J Pharm Life Sci, 2, pp. 1183–1189.
  81. Salehi S.H., and Heshmat, G., 2017. Efficacy of Different Essential Oils, Uses in Case of Treatment and Control the Head Lice. Int J of Adv Res, 5(Apr), pp. 2044-2047.
  82. Samuel, A.J.S.J., et al., 2009. In vitro screening of anti-lice activity of Pongamia pinnata leaves. The Korean J of parasitology, 47(4), p. 377.
  83. Sana, S.H., 2020. A comprehensive review of the pharmacological potential of Aristolochia longa Linn. European J of Pharmaceutical and Medical Research, 7(8), pp. 366–368.
  84. Sharma, A., Shailajan, S., and Menon, S., 2009. Individual and Synergistic Effects of Leaf Powders of Annona Squamosa linn., Datura Metel Linn., Vitex Negundo Linn., and their Combination on Pediculus Humanus. J of Herbal Medicine and Toxicology, 3(2), pp. 105–110.
  85. Shirazi, M.H., 2007. Qarabadin-e-Kabir. Tehran: Institute of Medical History, Islamic and Complementary Medicine Studies, Iran University of Medical Sciences Publications.
  86. Shrivastava, V., and Jain, U., 2010. In-vitro Pediculicidal Activity of Juice from Clove of Allium sativum. Research J of Pharmacy and Technology, 3(4), pp. 1134–1135.
  87. Sittichok, S., Wongnet, O., and Soonwera, M., 2018. New Thai herbal shampoos as pediculicides for killing head louse, Pediculus humanus capitis De Geer (Phthiraptera). Asian Pacific J of Tropical Biomedicine, 8(2), pp. 106–112.
  88. Sreedhar, V., et al., 2020. Pharmacological Screening of Anti Lice and Antidandruff Activity of Ethanolic Extract of Leaves of Datura metel. Pharmacognosy J, 12(6s), pp. 1653-1657.
  89. Su, M., and Mulla, M., 1999. Activity and biological effects of neem products against arthropods of medical and veterinary importance. J Am Mosq Control Assoc, 15, pp. 133–152.
  90. Susanty, E., et al., 2020. In Vitro Test on the Effectiveness of Citrus limon and Allium sativum as Pediculicides. J Kedokteran Brawijaya, 31(2), pp. 89–94.
  91. Toloza, A.C., et al., 2008. Interspecific hybridization of Eucalyptus as a potential tool to improve the bioactivity of essential oils against permethrin-resistant head lice from Argentina. Bioresource Technology, 99(15), pp. 7341–7347.
  92. Upadhyay, S., Ghosh, A., and Singh, V., 2011. Anti-lice activity of Abrus precatorius Linn (FAM-Fabaceae) seed oil. Egypt Dermatol Online J, 7, p. 4.
  93. Valnet, J., 1990. The practice of aromatherapy: A classic compendium of plant medicines and their healing properties. Rochester, Vermont, US: Inner Traditions/Bear & Co.
  94. Veal, L., 1996. The potential effectiveness of essential oils as a treatment for headlice, Pediculus humanus capitis. Complementary Therapies in Nursing and Midwifery, 2(4), pp. 97–101.
  95. Vicentini, C.B., Manfredini, S., and Contini, C., 2018. Ancient treatment for lice: a source of suggestions for carriers of other infectious diseases? Infez Med, 26, pp. 181–192.
  96. Weems, H., and Fasulo, T., 2015. Human lice: body louse, Pediculus humanus humanus Linnaeus and head louse, Pediculus humanus capitis De Geer (Insecta: Phthiraptera (Anoplura): Pediculidae). The document of EENY. pp. 103-104. Available at: https://edis.ifas.ufl.edu/publication/IN261 [Accessed 17 October 2023]
  97. Yadav, R.D., et al., 2011. Pongamia pinnata: an overview. Int J of Pharmaceutical Sciences and Research, 2(3), p. 494.
  98. Yang, Y.-C., et al., 2003. Ovicidal and adulticidal effects of Eugenia caryophyllata bud and leaf oil compounds on Pediculus capitis. J of Agricultural and Food Chemistry, 51(17), pp. 4884–4888.
  99. Yang, Y.-C., et al., 2004. Insecticidal activity of plant essential oils against Pediculus humanus capitis (Anoplura: Pediculidae). J of Medical Entomology, 41(4), pp. 699–704.
  100. Yang, Y.-C., et al., 2005. Ovicidal and adulticidal activities of Cinnamomum zeylanicum bark essential oil compounds and related compounds against Pediculus humanus capitis (Anoplura: Pediculicidae). Int J for Parasitology, 35(14), pp. 1595–1600.
  101. Yones, D.A., Bakir, H.Y., and Bayoumi, S.A., 2016. Chemical composition and efficacy of some selected plant oils against Pediculus humanus capitis in vitro. Parasitology Research, 115, pp. 3209–3218.
  102. Yoon, K.S., et al., 2004. Resistance and cross-resistance to insecticides in human head lice from Florida and California. Pesticide Biochemistry and Physiology, 80(3), pp. 192–201.