Toxic Lice Treatment

The United States Food and Drug Administration (FDA) announced significant updates to the labeling of products containing lindane (hexachlorocyclohexane) to include additional warnings about the potential risks associated with its use and misuse, according to a recent report released by the FDA. Lindane lotions and shampoos are used in the treatment of lice and scabies but may have toxic side effects if not used appropriately.

Lice (Pediculus humanus capitis) are parasites that most commonly affect children between the ages of 3 and 10 and are transmitted by direct head-to-head contact. Girls are more often affected than boys, due to longer hair and sharing of hair care accessories. There are an estimated 6 to 12 million new cases of head lice each year in the United States. Treatment involves using a special comb to remove lice from the hair and applying a topical agent to the head to kill the organisms. Contamination of bedding and clothing is common, which warrants washing any fabric the infected child has come into contact with thoroughly in hot water.

The new labeling on lindane products will include a boxed warning that anyone weighing less than 110 pounds (50 kg) use them with caution and that infants should not be treated with them at all. Other label changes will include a warning of potential adverse reactions in people with compromised immune systems or in those taking antidepressant medications. Toxicity of lindane lotion appears to be higher than that of lindane shampoo. Due to the potential toxic effects, the FDA states that lindane products should only be used if all other treatments for lice have failed.

Lindane is one of several chemicals in the family of pesticides called organochlorines and is one of the oldest pesticides used in the United States. It is similar to the more well-known pesticide DDT that was banned in the United States more than 30 years ago. While few reports of toxicity have been reported when lindane products were used correctly, misuse and overuse has led to symptoms of nausea, vomiting, coordination problems, dizziness, fatigue, and, in some cases, seizures. Animal studies suggest lindane causes cancer, but human studies have been inconclusive.

Other natural treatments may be an effective, safer way to treat lice. One study showed that applying a shampoo (by Nature’s Sunshine Products) containing 0.5% paw paw (Asimina triloba), 0.5% tea tree oil (Melaleuca alternifolia), and 1% thyme oil (Thymus vulgaris) was 100% effective in removing head lice from 16 infected children. The treatment regimen used was a single application, repeated every eight days, for a total of three applications. The shampoo was left in the children’s hair for 30 minutes for the first treatment and then 60 minutes for the subsequent treatments before rinsing.

Physicians recommend that parents examine their children regularly and start treatment as soon as possible once a child becomes infected.

Darin Ingels, ND, MT (ASCP), received his bachelor’s degree from Purdue University and his Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Ingels is the author of The Natural Pharmacist: Lowering Cholesterol (Prima, 1999) and Natural Treatments for High Cholesterol (Prima, 2000). He currently is in private practice at New England Family Health Associates located in Southport, CT, where he specializes in environmental medicine and allergies. Dr. Ingels is a regular contributor to Healthnotes and Healthnotes Newswire.

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