Treatment of scabies lindane preparations

Risks and benefits involved in the use of lindane preparations for the treatment of scabies and head louse infestations are evaluated. Although lindane per se is moderately toxic, capable of inducing neurotoxic and hemotoxic effects, there is little evidence that the preparations used in the treatment of scabies and pediculosis give rise to toxic symptoms when applied according to directions. Current evidence does not support the view that lindane is intrinsically carcinogenic, although very high doses have induced hepatomas in mice. It is concluded that the benefits obtained in the use of lindane as a scabicide and pediculicide outweigh risks involved in its use for these purposes. Comparison with other preparations available for the control of scabies and pediculosis indicates that lindane is probably the most effective scabicide, although it also shows the greatest toxic potential. Malathion and pyrethrin preparations seem equally effective against head lice. Suggestions for even safer use of lindane are discussed. (J AM ACAD DERMATOL 5:517-527, 1981.) This report evaluates the risks and benefits in- volved in the use of the pesticide lindane* for the treatment of scabies and pediculosis in man. Evi- dence for the effectiveness of lindane against scabies was demonstrated in 1948, l'z only a few years after it had been shown to have potent insec- ticidal capabilities. ~ Note was also made of the treatment with lindane of a group of patients with pediculosis corporis and pediculosis pubis, with good results. 2 A careful scientific study of the ef- fects of lindane against scabies and pediculosis was carried out by Spfihler,4 who demonstrated its effectiveness against both adult lice and nits. Lin- dane has subsequently become widely used for the treatment of scabies and pediculosis and is gen-