Editor, – In reply to a question about whether lindane should be used for the treatment of scabies ('Letters' Aust Prescr 1997;20:32), you did not distinguish between the use of lindane in adults and children.
Ginsberg et al1 studied percutaneous absorption of lindane in infants and children. They showed that blood levels peaked at 6 hours. Therefore, washing of the skin 6 or 8 hours after application was not likely to significantly reduce transcutaneous absorption of lindane.
A text on paediatric dermatology 4 recommends against the use of lindane for the treatment of scabies in infants and children. The Australian text on paediatric dermatology5 makes the same recommendation.
I think therefore that instead of discouraging the use of lindane for the treatment of scabies in infants and children, we should avoid it.
On a separate issue, a textbook on dermatology6 recommends that the treatment of Norwegian (crusted) scabies is as for ordinary scabies, although several applications of a scabicide may be necessary.
James A. Keipert
East Melbourne, Vic.
- Ginsberg CM, Lowry W, Reisch JS. Absorption of lindane (gamma benzene hexachloride) in infants and children. J Pediatr 1977;91:998-1000.
- Pramanik AK, Hansen RC. Transcutaneous gamma benzene hexachloride absorption and toxicity in infants and children. Arch Dermatol 1979;115:1224-5.
- Lee B, Groth P. Scabies: transcutaneous poisoning during treatment [letter]. Pediatrics 1977;59:643.
- Schachner LA, Hansen RC, editors. Pediatric dermatology. 2nd ed. New York: Churchill Livingstone, 1995:1378-9.
- Keipert JA. Essential pediatric dermatology. Chur, Switzerland: Harwood Academic Publishers, 1990:92.
- Champion RH, Burton JL, Ebling FJ, editors. Textbook of dermatology. 5th ed. Oxford: Blackwell Scientific Publications, 1992:1306.