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Three Part Question

In [a child with pediculosis capitis infestation] is [wet combing alone] effective in [eradicating the parasites] ?

Clinical Scenario

A 6-year-old boy presents to the paediatric emergency department complaining of pruritus affecting his scalp. On examination you notice several nits attached to his hair as well as a few adult head lice. You are considering treatment with pediculocides, but his mother is rather reluctant to use "chemicals". You consult the BNF for children, which apart from listing three classes of pediculocides – carbaryl, malathion and pyrethroids (permethrin and phenothrin) – outlines the option of using wet combing as an alternative. You wonder whether there is good evidence to support the sole use of this intervention in head lice infestation.