ABSTRACT
Although lindane and malathion have been widely used for treatment of ectoparasite infections of humans (scabies, and body, head, and pubic lice), because of concerns regarding significant toxic side effects and resistance, their use has significantly declined. Indeed, the medical use of lindane has been prohibited in an increasing number of countries, and in some it has been abandoned in agricultural use. Other countries have allowed lindane to remain registered as a prescription drug, even though it is no longer permitted to be used in agriculture. In 2002, the sale of lindane for the treatment of scabies and head lice was prohibited in California, and in 2003 the U.S. Food and Drug Administration (FDA) issued a warning on its use and downgraded it to second-line treatment for pediculosis and scabies (FDA, 2003). These guidelines were updated in 2015. Lindane remains registered in the United States as a second-line therapy for scabies and lice infestations. The European Union prohibited the use of lindane as an insecticide in late 2007, and at that time it was withdrawn from sale as therapy (van den Hoek et al., 2008). The World Health Organization (WHO) has classified lindane as “moderately hazardous” (WHO, 2004). The long-term environmental stability of lindane has resulted in its being considered for inclusion in the list of persistent organic pollutants (POPs). Persistant organic pollutants are substances persisting in the environment that pose a risk to human health.
