Treatment of pediculosis pubis. Clinical comparison of efficacy and tolerance of 1% lindane shampoo vs 1% permethrin creme rinse.

Pediculosis pubis (PP) is a common sexually transmitted disease. Current therapy with 1% lindane or various synergized pyrethrins as a single dose has been accepted as adequate by the medical community. We treated 53 men with the diagnosis of PP with either 1% lindane (Kwell) shampoo for four minutes or 1% permethrin (Nix) creme rinse for ten minutes, according to random assignment. All patients combed with fine-toothed combs immediately after therapy. They were examined for tolerance and efficacy at 24 to 48 hours and again at ten days (eight- to 12-day range). In the lindane group, ten (40%) of 25 subjects were infested at the final assessment. In the permethrin group, 12 (43%) of 28 subjects were infested at the final assessment. The difference was not statistically significant. Both treatments were well tolerated, with one mild adverse reaction in each group. We concluded that both agents were equivalent in the treatment of PP. On the basis of the high failure rate, we propose that the therapy of PP with any agent should include a second treatment at ten days.