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Editor, – Can you please explain why benzene hexachloride (lindane) lotion is still available for the treatment of scabies and other ectoparasites. The class of chemicals to which lindane belongs has been adjudged to be so toxic that it cannot be used to protect buildings against termites. How is it therefore that this organochlorine insecticide is still in use medically?

F. Winter
General Practitioner
Vaucluse, N.S.W.

The Editor comments:
Advice from the Therapeutic Goods Administration and the Medicines Evaluation Committee of Victoria suggests that lindane is unlikely to cause problems if used correctly. Although lindane is more extensively absorbed through the skin than permethrin1, it is important to have a drug to treat Norwegian scabies or to be used where there is resistance to other treatments. Lindane is probably only going to be used once in a patient's life, so the risk of chronic adverse effects is unlikely to be a problem as any absorbed drug is rapidly eliminated. Ecotoxicity does not always equate to human toxicity.

Although lindane has been used for many years, its use is now discouraged because safer drugs are available for the treatment of scabies. Currently recommended treatments are permethrin and benzyl benzoate.2