Summary about Disease
Pubic lice, also known as crabs, are tiny parasitic insects that infest the genital area and lay their eggs (nits) on pubic hair. They feed on human blood. Although usually found in the pubic hair, they can sometimes be found on other coarse body hair, such as eyelashes, eyebrows, beard, chest hair, and armpits. Pubic lice are usually spread through sexual contact, but can also be transmitted through close personal contact or by sharing contaminated items like clothing, bedding, or towels.
Symptoms
Intense itching in the genital area
Visible lice or nits (eggs) on pubic hair
Blue or grayish spots on the skin in the affected area (caused by lice bites)
Low-grade fever
Irritability
Causes
Sexual Contact: Most common cause is skin-to-skin contact during sexual activity with someone who has pubic lice.
Close Personal Contact: Less commonly, spread through close physical contact with an infected person, even if not sexual.
Contaminated Items: Sharing bedding, clothing, or towels with someone who has pubic lice. Note: lice cannot live long away from the human body.
Medicine Used
Over-the-Counter (OTC) Medications: Permethrin lotion 1% (Nix) and pyrethrins with piperonyl butoxide (Rid) are common OTC treatments. Follow instructions carefully.
Prescription Medications: If OTC treatments don't work, a doctor may prescribe stronger medications like malathion lotion 0.5% (Ovide), ivermectin (Stromectol) oral medication, or lindane shampoo (rarely used due to potential side effects).
Is Communicable
Yes, pubic lice are highly communicable.
Precautions
Avoid Sexual Contact: Refrain from sexual activity until treatment is complete and you and your partner(s) are clear of lice.
Wash Bedding and Clothing: Wash all bedding, clothing, and towels used in the 2-3 days before treatment in hot water and dry on high heat. Items that cannot be washed can be dry-cleaned.
Avoid Sharing Personal Items: Do not share clothing, towels, or bedding with others.
Inform Sexual Partners: Notify all recent sexual partners so they can get tested and treated.
Treat All Household Members: If one family member has pubic lice, all household members should be examined and treated if necessary.
How long does an outbreak last?
An outbreak lasts until treated. Without treatment, pubic lice can persist indefinitely. With proper treatment using recommended medications, the lice and nits should be eliminated within a few days to a couple of weeks. Itching may persist for a short time even after successful treatment.
How is it diagnosed?
Visual Examination: A healthcare provider can usually diagnose pubic lice by visually examining the pubic area for lice or nits.
Magnifying Glass: A magnifying glass may be used to help identify the lice or nits.
Timeline of Symptoms
Initial Infestation: It may take several days to weeks after infestation for itching to begin.
Itching Onset: Intense itching usually develops within a few weeks of becoming infested.
Visible Lice/Nits: Lice and nits may be visible after itching starts, but can be difficult to spot initially.
Symptoms Persist: Without treatment, symptoms will continue and may worsen over time.
Important Considerations
Secondary Infections: Excessive scratching can lead to skin irritation and secondary bacterial infections.
Co-infections: People with pubic lice are also at higher risk for other sexually transmitted infections (STIs) and should be screened for these.
Treatment Failure: Resistance to some medications can occur. If OTC treatments are ineffective, consult a doctor for prescription options.
Eyelash Infestation: If eyelashes are infested, petroleum jelly (Vaseline) can be applied to the eyelids twice a day for several days to smother the lice. See a doctor if this does not work.