Lindane for lice
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Lindane is available by prescription as a lotion, cream, or shampoo to treat lice. Treatment needs to be repeated 1 week after the first dose.
Lindane can cause serious side effects if you do not use it exactly as directed. Lindane lotion or cream (for pubic lice) should be applied and rubbed into cool, dry skin and hair. If it is applied to warm, moist skin (such as right after a bath or shower), it will be absorbed quickly by the skin and could cause side effects. The lotion is left on for 8 to 12 hours and then washed off.
Lindane shampoo (for head lice) is applied to dry hair and thoroughly rubbed into the hair and scalp. It is left on for 4 minutes, worked into a lather with a small amount of water, and rinsed well.
How It Works
Lindane kills lice but does not kill lice eggs (nits). Newly hatched lice are killed during the second treatment.
Why It Is Used
Lindane may be used when other products fail to get rid of lice or when a person cannot use any of the other products. The shampoo may be used to treat head lice, and the lotion or cream may be used to treat pubic lice.
Lindane was the drug of choice for treating lice for many years, but now it is not the preferred treatment. Permethrin (Nix) works better and is less likely to cause side effects.
Lindane should not be used by pregnant women, nursing mothers, children less than 2 years old, people who have seizure disorders, or people who have certain skin diseases that may increase the likelihood that the product will be absorbed into their skin.
How Well It Works
Lindane can be effective at treating head and pubic lice.
When used as directed, lindane is safe and has few side effects. However, it is easily absorbed into the skin and can cause negative side effects when it is not used properly. If lindane is left on the skin too long, used repeatedly, or eaten, it can cause nervous system side effects, such as seizures, especially in young children.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
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 does contain potentially harmful toxins.3
Lindane is no longer the treatment of choice for head and pubic lice because it is more likely to cause side effects than permethrin (Nix).
If you are going to use lindane on a small child, dress the child in clothing that covers the entire body and be sure he or she does not lick his or her skin. Put socks on the child's hands to prevent licking of the hands. If the child cannot be prevented from licking the skin, try permethrin or other lice treatment products instead.
Overuse of lice medicines (such as reapplying the lotion when only a single use is prescribed) can irritate the skin and may increase the risk of side effects from some products. It is common for itching to persist for 7 to 10 days after treatment. Itching is not a reason to treat the person again.
- Frankowski BL, et al. (2002). Head lice. Pediatrics, 110(3): 638–642.
- American Academy of Pediatrics (2006). Pediculosis capitis (head lice), pediculosis corporis (body lice), pediculosis pubis (pubic lice). In LK Pickering, ed., Red Book: 2006 Report of the Committee on Infectious Diseases, 27th ed., pp. 488–493. Elk Grove Village, IL: American Academy of Pediatrics.
- U.S. Food and Drug Administration (2003). FDA advisory: Lindane. American Family Physician, 68(4): 764.
Last Updated: November 24, 2008
Author: Debby Golonka, MPH