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Head lice and scabies: avoid lindane

Lindane, still used in some head lice and scabies treatments, does more harm than good. There are other, better alternatives.

Treatments based on lindane (an organochlorine derivative) can be neurologically toxic, and have lost effectiveness against head lice.

Drugs based solely on lindane powder went off sale in France in 2001, while creams remained on the market. Products containing lindane for local application are still legally available over the counter.

The French regulatory agency was to review the position of lindane as a treatment. The marketing authorisation body suggested adding lindane to the list of prescription-only drugs, but that is pending a re-evaluation of veterinary products containing lindane. Currently there is only one treatment containing lindane still on the French market, Elenol° cream. Official information on this drug does not take account of World Health Organization (WHO) recommendations, which contra-indicates lindane in children under the age of 10, and during pregnancy and breastfeeding.

Recent scientific recommendations advocate the withdrawal of lindane in favour of other more effective and safer treatments: pyrethrines and malathion against head lice, and benzyl benzoate, even oral ivermectine against scabies.

©Prescrire April 2005

Source: "Lindane : toujours sur liste II et exonéré pour l’application sur la peau " Rev Prescrire 2005 ; 25 (260) : 266.

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