Lindane 1% for scabies

Lindane is a chemical that kills the scabies mite.

Lindane is available as a cream or lotion. It is applied to the skin and left on for 8 hours before being washed off with lukewarm, soapy water. Follow these instructions for using scabies medications.

Lindane cream or lotion can cause serious side effects if you do not use it exactly as directed. General precautions include:

• Only applying it on cool and dry skin. Chemicals in lindane absorb quickly and easily. If it is applied after bathing when skin is warm and moist, lindane is more likely to become toxic and cause side effects.
• Never applying the medication more than once without first seeing your doctor. Itching may continue even after all the mites have been killed. If you itch, it doesn't mean that you still have scabies. Talk to your doctor, who may advise you to take an antihistamine or other medication.

Lindane is an insecticide used to kill parasites on animals and humans. It can be used to treat scabies, but usually only as a second-line treatment.¹ This means that lindane should be used only after another medication, usually permethrin (Elimite), is tried first. This is because lindane can cause dangerous side effects in certain people or if it is not used exactly as directed.

Lindane should not be used to treat:

• Pregnant women or women who are breast-feeding.²
• Babies, small children, older adults, and anyone who weighs less than 110 lb (50 kg).¹
• People who have seizure disorders or other nervous system problems.
• People who are taking antidepressants or certain other medications that increase their risk of developing seizures from lindane.³
• People who have large areas of broken skin, open sores or areas that are inflamed, or crusted (scabby) skin.²
• People who have impaired immune systems, as from HIV infection.¹

A single application of lindane will usually cure scabies.

The scabies mite may be able to develop a tolerance to lindane, rendering the medication less effective.

Lindane can have dangerous central nervous system (neurotoxic) effects because it can become toxic when high amounts are absorbed into the bloodstream. Most serious side effects are related to misuse or overuse.³

Possible side effects can include:

• Nausea and vomiting.
• Breathing problems.

Rare yet severe side effects include:

• Dizziness.
• Seizures.
• Central nervous system damage.
• Aplastic anemia, which is a condition that affects how your body produces blood cells.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

Permethrin is the preferred medication for treating scabies, but lindane is prescribed in special cases, such as when a person has an allergic reaction to permethrin. When it is used correctly, lindane is considered a safe and effective treatment for scabies. The U.S. Food and Drug Administration (FDA) has issued an advisory to use this product exactly as labeled. Although most of the side effects reported from this product are from misuse and overuse, it contains potentially harmful toxins that can affect the central nervous system.

If your health professional prescribes lindane to treat scabies, make sure you receive, understand, and follow detailed instructions for using it correctly.

Lindane is sometimes used (with caution) on children who weigh less than 110 lb (49.9 kg).³

The state of California has banned lindane products for treating human cases of scabies or lice.⁴

Itching commonly continues for up to several weeks after treatment with a scabies medication. This doesn't mean that the scabies mites are still alive; it means that the body is still reacting to the mites and their feces. Do not apply scabies medication more than once. Not only do you increase the risk of side effects, but also you will likely irritate your skin, and you may itch even more. Talk to your doctor about other medications you can take, such as antihistamines, to help relieve your symptoms.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Citations

1. Drugs for parasitic infections (August 2004). Medical Letter on Drugs and Therapeutics. Available online: http://www.medicalletter.org.

2. Centers for Disease Control and Prevention (2006). Sexually transmitted diseases treatment guidelines, 2006. MMWR, 55(RR-11): 79–80.

3. U.S. Food and Drug Administration (2003). FDA issues health advisory regarding labeling changes for lindane products. FDA Talk Paper T03-19. Available online: http://www.fda.gov/bbs/topics/ANSWERS/2003/ANS01205.html.

4. Stone SP (2003). Scabies and pediculosis. In IM Freedberg et al., eds., Fitzpatrick's Dermatology in General Medicine, 6th ed., vol. 2, chap. 238, pp. 2283–2289. New York: McGraw-Hill.