Pyrethroid-induced paresthesia--a central or local toxic effect?

BACKGROUND: Pyrethroid-induced paresthesia is frequently seen after dermal exposure to pyrethroids. Affected individuals experience a sensation of burning, tingling, itching, or numbness, most commonly in the face. This occurs 1-2 hours after the beginning of exposure and resolves spontaneously. MECHANISMS: Paresthesia occurs as a result of a direct effect on intracutaneous nerve endings at very low pyrethroid doses. It is related to potency of the pyrethroid with pyrethroids without an alpha-cyano group generally showing the weakest effect.
CONCLUSION: Doses sufficient to cause paresthesia are far lower than those causing central or systemic toxicity. Paresthesia is therefore considered to be a localized nuisance effect. The best advice to affected individuals is to prevent paresthesia from occurring through appropriate hygiene measures and personal protection.