Comparative Study of 5% Permethrin Cream and 1% Lindane Lotion for the Treatment of Scabies

Abstract

A multicenter, randomized, investigator-blind controlled trial was conducted to compare the safety and efficacy of a single, whole-body application of 5% permethrin cream with that of 1% lindane lotion for the treatment of scabies in 467 patients. At 14 +/- 3 days after treatment, the mean active lesion count decreased from pretreatment levels of 85 (range, 4 to 600) in both treatment groups to 14 (range, 0 to 133) in the permethrin group and to 15 lesions (range, 0 to 500) in the lindane group. At 28 +/- 7 days after treatment, complete resolution had occurred in 181 (91%) of 199 patients treated with permethrin and in 176 (86%) of 205 patients given lindane. Pruritus due to scabies persisted at 28 +/- 7 days in 14% of the permethrin group and in 25% of the lindane group. The most frequent adverse effects were new or increased pruritus and mild, transient burning or stinging; the latter was slightly more frequent following permethrin treatment and appeared to be related to severity of infestation. Because of a lower potential for neurologic toxicity, permethrin may be preferable to lindane for the treatment of scabies particularly in children.

Topical permethrin and oral ivermectin in the management of scabies: A prospective, randomized, double blind, controlled study

“…[18] Oral ivermectin resulted in headache and nausea in four and two patients respectively that subsided spontaneously without any active intervention. Burning/stinging sensation was reported in 9.9%, pruritus in 6.4%, erythema in 2.1%, pain in 1.7%, tingling in 0.9% patients by Schultz et al, [6] as side effects of permethrin, while Chouela et al, [7] reported hypotension, abdominal pain, and vomiting with ivermectin.…”

“…[4] Permethrin 5% cream has been found to be more effective as compared to lindane and is FDA approved for the treatment of scabies. [5,6] In developing countries like India where the disease is largely prevalent in the lower socioeconomic strata, acquiring permethrin is considered an expensive option. Besides, whole body application for hours together is inconvenient and leads to poor compliance.…”

Norwegian Scabies in a Patient with Acquired Immunodeficiency Syndrome

“…Norwegian scabies may respond to Lindane plus keratolytics, but multiple applications of Lindane may be required to eradicate the large number of mites seen in Norwegian scabies, and relapses are frequent. Whole-body application of 5% permethrin cream was found to be a safe and effective alternative to 1% lindane lotion for the treatment of ordinary scabies in both adults and children [15, 16]. Recently 2 patients with crusted scabies who failed to respond to topical benzyl benzoate have successfully been treated with a single oral dose of ivermectin [11].…”

A Systematic Review of the Treatment of Scabies

“…[1][2][3][4][5][6][7][8][9][10][11] Seven studies assessed the effectiveness of specific drugs: benzyl benzoate, crotamiton, lindane, ivermectin, and permethrin (Table). In 4 of the trials, close and family contacts in intervention and control groups were treated.…”