Safety of Permethrin vs Lindane for the Treatment of Scabies

Comparative In Vitro Pediculicidal Efficacy of Treatments in a Resistant Head Lice Population in the United States

“…Increasing the treatment time, which we have seen many parents do in an effort to increase efficacy, could result in increased percutaneous absorption and toxic effects on the central nervous system. 3,19 Ovide lotion was equally effective in the present study as in Update 2000, 1 killing 100% of lice within 20 minutes at both sites. The only other product tested that killed all lice in both sites at 3 hours was A-200 shampoo.…”

Ivermectin alone or in combination with benzyl benzoate in the treatment of human immunodeficiency virus-associated scabies

“…Until recently, 1% lindane (gamma‐benzene hexachloride) was a commonly used scabicide, but concerns about adverse effects and the possible development of resistance 14–17 have contributed to declining usage. Permethrin 5% cream is now considered by many to be the best topical treatment presently available, 13,18 , 19 but BBS, which is the only topical treatment currently available in our hospital, is a long‐established and effective alternative 20,21 . However, although topical agents are effective in the management of classical scabies, they are less successful in dealing with severe/crusted scabies.…”

European guideline for the management of scabies, 2010

“…Eight randomized controlled trials of antiscabietic treatment have been published since the previous guideline. 4 -13 † Permethrin cream 5% (once for 8 -14 hours) is effective, 9,14 well-tolerated, 15,16 but expensive (level of evidence Ib; grade A recommendation); † Benzyl benzoate lotion (10 to 25%) is also cheap and effective, but requires application on more than one day (2-3 applications) 11 (level of evidence III; grade B recommendation); † Ivermectin is not licensed in most countries, but can be given orally as a repeated dose (200 mg/kg) two weeks apart in patients weighing more than 15 kg. Comparisons with lindane and benzyl benzoate give conflicting results with regard to efficacy 4 -6,11,17,18 (level of evidence Ib; grade A recommendation).…”