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Lindane is the gamma isomer of hexachlorocyclohexane. It has been used in the past as an insecticide but has not been produced in the United States since 1976. It is imported, however, and is used in lotions and shampoos for the treatment of scabies and lice. It is easily absorbed through the skin and in toxic amounts can result in blood disorders, dizziness, headaches, and may even affect levels of sex hormones in the blood. The US EPA and the International Agency for Research on Cancer (IARC) has determined that there is suggestive evidence that lindane is carcinogenic. Lindane is lipid soluble and can easily be transported via the placental barrier and mother’s milk, thereby reaching the fetus and affecting the neurologic development of the neonate. Lindane absorbed through the skin easily passes through the blood-brain barrier and has been shown to produce seizures in adults and children as well as mental retardation in neonates. A report involving dermal absorption of lindane from lotions for scabies is provided below as well as selected references on this subject.

Selected References

Alter, B. P., Potter, N. U. and Li, F. P., Classification and aetiology of the aplastic anemias. Clinical Haematology, 7(3), 431-465 (1978).

Anonymous, Gamma benzene hexachloride (Kwell) alert. Food and Drug Administration Drug Bulletin, 6, 28 (1976).

Anonymous, Lindane: serious neurological effects. Prescrire International, 15(82), 61 (2006).

Aoki, K. and Shimizu, H., Epidemiology of leukemia and aplastic anemia., National Cancer Institute Monograph, Volume 47, 23-30 (1977).

Agency for Toxic Substances and Disease Registry (ATSDR), Toxicological profile for alpha-, beta-, gamma-, and delta-hexachlorocyclohexane.  Agency for Toxic Substances and Disease Registry (ATSDR), Prepared by Research Triangle Institute Under Contract No. 205-93-0606, US Department of Health and Human Services, Public Health Service, September (1997).

Baumann, K., Behling, K., Brassow, H. L. and Stapel, K., Occupational exposure to hexachlorocyclohexane.  III. Neurophysiological findings and neuromuscular function in chronically exposed workers. International Archives of Occupational and Environmental Health, 48(2), 165-172 (1981).

Bhalla, M. and Thami, G. P., Reversible neurotoxicity after an overdose of topical lindane in an infant. Pediatric Dermatology, 21(5), 597-599 (2004).

Boffa, M. J., Brough, P. A. and Ead, R. D., Lindane neurotoxicity. British Journal of Dermatology, 133(6), 1013 (1995).

Davies, J. E., Dedhia, H. V., Morgade, C., Barquet, A. and Maibach, H. I., Lindane poisonings. Archives of Dermatology, 119(2), 142-144 (1983).

Desi, I., Neurotoxicological effect of small quantities of lindane. Internationales Archiv Fur Arbeitsmedizin, 33, 153-162 (1974).

Dick, I. P., Blain, P. G. and Williams, F. M., The percutaneous absorption and skin distribution of lindane in man. I. In vivo studies. Human and Experimental Toxicology, 16, 645-651 (1997).

Dzierzawski, A., Embryo-toxicity studies of lindane in the golden hamster, rat and rabbit. Bulletin of the Veterinary Institute in Pulawy, 21, 85-93 (1977).

Gewin, H. M., Benzene hydrochloride and aplastic anemia. Journal of the American Medical Association, 171, 1624-1625 (1959).

Gilbert, M. E. and Mack, C. M., Seizure thresholds in kindled animals are reduced by the pesticides lindane and  endosulfan. Neurotoxicology Teratology, 17(2), 143-150 (1995).

Grizzle, C. O., Lindane induced neuropathy. Rocky Mountain Medical Journal, 66, 42-43 (1969).

Herbst, M. and Bodensatein, G., Toxicology of lindane. In:  Lindane.  Ulman, E. (ed). Verlag, Frieburg, 23-78 (1974).

International Agency for Research on Cancer (IARC), Hexachlorocyclohexane (technical HCH and lindane), International Agency for Research on Cancer Monographs on the Evaluation of the Carcinogenic Risks of Chemicals to Humans, Volume 20, 195-239 (1979).

Joy, R. M. and Albertson, T. E., Lindane and limbic system excitability. Neurotoxicology, 6(2), 193-214 (1985).

Kurt, T. L., Bost, R., Gilliand, M., Reed, G. and Petty, C., Accidental Kwell (lindane) ingestions. Veterinary and Human Toxicology, 28, 569-571 (1986).

Lifshitz, M. and Gavrilov, V., Acute lindane poisoning in a child. Israel Medical Association Journal, 4(9), 731-732 (2002).

Loge, J. P., Aplastic anemia following exposure to benzene hexachloride (lindane). Journal of the American Medical Association, 193(2), 110-114 (1965).

McNamara, B. G. P., Benzene hexachloride poisoning. British Medical Journal, 3, 585 (1970).

McNutt, T. L. and Harris, C., Lindane embryotoxicity and differential alteration of cysteine and glutathione levels in rat embryos and visceral yolk sac. Reproductive Toxicology, 8, 351-362 (1994).

Mead, R. J., Lindane, Kwell, and aplastic anemia. Postgraduate Medicine, 72(1), 28, 30 (1982).

Milby, T. H., Ottoboni, F., Samuels, A. J., Human exposure to lindane. Blood lindane levels as a function of exposure. Journal of Occupational Medicine, 10(10), 584-587 (1968).

Nordt, S. P. and Chew, G., Acute lindane poisoning in three children. Journal of Emergency Medicine, 18(1), 51-53 (2000).

Palmer, A. K., Bottomley, A. M., Wordern, A. N., Frohberg, H. and Bauer, A., Effect of lindane on pregnancy in rat. Toxicology, 9(3), 239-247 (1978).

Powell, G. M., Toxicity of lindane. Central African Journal of Medicine, 26, 170 (1980). 

Rasmussen, J. E., The problem of lindane. Journal of the American Academy of Dermatology, 5(5), 507-516 (1981).

Rauch, A. E., Kowalsky, S. F., Lesar, T. S., Sauerbier, G. A., Burkart, P. T. and Scharfman, W. B., Lindane (Kwell)-induced aplastic anemia. Archives of Internal Medicine, 150, 2393-2395 (1990).

Samuels, A. J. and Milby, T. H., Human exposure to lindane. Clinical, Hematological and biochemical effects. Journal of Occupational Medicine, 13(3), 147-151 (1971).

Soloman, L. M., Fahrner, L. and West, D. P., Gamma benzene hexachloride toxicity. A review. Archives of Dermatology, 113, 353-357 (1977).

Starr, Jr., H. G., and Clifford, N. J., Acute lindane intoxication: A case study. Archives of Environmental Health, 25(5), 374-375 (1972).

Telch, J. and Jarvis, D. A., Acute intoxication with lindane (gamma benzene hexachloride). Canadian Medical Association Journal, 126, 662-663 (1982).

Tenenbein, M., Seizures after lindane therapy. Journal of the American Geriatric Society, 39(4), 394-395 (1991).

West, I., Lindane and hematologic reactions. Archives of Environmental Health, 15, 97-101 (1967).

Wheeler, M., Gamma benzene hexachloride (Kwell) poisoning in a child. Western Journal of Medicine, 126(6), 518-521 (1977).

Wooltorton, E., Concerns over lindane treatment for scabies and lice. Canadian Medical Association Journal, 168(11), 1447-1448 (2003).

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