CDC – Lice – Pubic “Crab” Lice

A lice-killing lotion containing 1% permethrin or a mousse containing pyrethrins and piperonyl butoxide can be used to treat pubic (“crab”) lice. These products are available over-the-counter without a prescription at a local drug store or pharmacy. These medications are safe and effective when used exactly according to the instructions in the package or on the label.

Lindane shampoo is a prescription medication that can kill lice and lice eggs. However, lindane is not recommended as a first-line therapy. Lindane can be toxic to the brain and other parts of the nervous system; its use should be restricted to patients who have failed treatment with or cannot tolerate other medications that pose less risk. Lindane should not be used to treat premature infants, persons with a seizure disorder, women who are pregnant or breast-feeding, persons who have very irritated skin or sores where the lindane will be applied, infants, children, the elderly, and persons who weigh less than 110 pounds.

Malathion* lotion 0.5% (Ovide*) is a prescription medication that can kill lice and some lice eggs; however, malathion lotion (Ovide*) currently has not been approved by the U.S. Food and Drug Administration (FDA) for treatment of pubic (“crab”) lice.

Both topical and oral ivermectin have been used successfully to treat lice; however, only topical ivermectin lotion currently is approved by the U.S. Food and Drug Administration (FDA) for treatment of lice. Oral ivermectin is not FDA-approved for treatment of lice.

How to treat pubic lice infestations: (Warning: See special instructions for treatment of lice and nits on eyebrows or eyelashes. The lice medications described in this section should not be used near the eyes.)

1. Wash the infested area; towel dry.
2. Carefully follow the instructions in the package or on the label. Thoroughly saturate the pubic hair and other infested areas with lice medication. Leave medication on hair for the time recommended in the instructions. After waiting the recommended time, remove the medication by following carefully the instructions on the label or in the box.
3. Following treatment, most nits will still be attached to hair shafts. Nits may be removed with fingernails or by using a fine-toothed comb.
4. Put on clean underwear and clothing after treatment.
5. To kill any lice or nits remaining on clothing, towels, or bedding, machine-wash and machine-dry those items that the infested person used during the 2–3 days before treatment. Use hot water (at least 130°F) and the hot dryer cycle.
6. Items that cannot be laundered can be dry-cleaned or stored in a sealed plastic bag for 2 weeks.
7. All sex partners from within the previous month should be informed that they are at risk for infestation and should be treated.
8. Persons should avoid sexual contact with their sex partner(s) until both they and their partners have been successfully treated and reevaluated to rule out persistent infestation.
9. Repeat treatment in 9–10 days if live lice are still found.
10. Persons with pubic lice should be evaluated for other sexually transmitted diseases (STDs).

Special instructions for treatment of lice and nits found on eyebrows or eyelashes:

• If only a few live lice and nits are present, it may be possible to remove these with fingernails or a nit comb.
• If additional treatment is needed for lice or nits on the eyelashes, careful application of ophthalmic-grade petrolatum ointment (only available by prescription) to the eyelid margins 2–4 times a day for 10 days is effective. Regular petrolatum (e.g., Vaseline)* should not be used because it can irritate the eyes if applied.

*Use of trade names is for identification purposes only and does not imply endorsement by the Public Health Service or by the U.S. Department of Health and Human Services.

This information is not meant to be used for self-diagnosis or as a substitute for consultation with a health care provider. If you have any questions about the parasites described above or think that you may have a parasitic infection, consult a health care provider.

Page last reviewed: September 12, 2019

Content source: Global Health, Division of Parasitic Diseases and Malaria

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Pubic lice | Terrence Higgins Trust

Sexual health information about pubic lice (also known as crabs), how they are passed on, pubic lice symptoms and treatment.

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Pubic lice – often called ‘crabs’ – are very common. They are tiny crab-shaped insects the size of a pinhead when fully grown. They usually cause itching, especially at night. You can buy treatment to get rid of pubic lice at a pharmacy without a prescription.

They’re easy to get. They live on body hair and feed on blood, but they cannot pass on HIV.

They live on pubic hair, underarm hair, hairy legs and chests and sometimes in eyebrows or facial hair – but not in the hair on your head.

Symptoms of public lice

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It’s possible to have pubic lice without noticing, but you will usually have the following symptoms several weeks after getting pubic lice:

• itching in the areas affected – this may be intense and usually worse at night
• irritated skin – possibly caused by scratching
• specks of blood on the skin where you have been bitten by lice
• blue specks on the skin
• black powder in your underwear, caused by lice droppings.

You might also be able to see the lice and their eggs (nits), which look like brown dots.

How they’re passed on

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Pubic lice move by crawling from hair to hair – they can’t fly or jump. Body contact during sex is the most common way pubic lice are passed on. However, if a person has pubic lice it doesn’t always mean it was passed on that way.

Lice can also be passed on through close body contact like hugging and kissing.

Lice can spread on towels, clothes, toilet seats and bedding (although this isn’t common). Because they need human blood to survive, they will only leave a body to move from one person to another. 

Unfortunately, using condoms and other forms of contraception will not protect you from getting pubic lice.

If you get them, you can stop them from spreading to others by:

• Washing bedding, towels and clothes on a hot wash (above 60°C) which will kill the lice and their eggs.
• Making sure anyone who you have had close contact with is treated. This includes sexual partners from the last three months and everyone in your household.

Treatment for public lice

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You don’t need to go to a clinic or see a doctor – though you may like to consider a full sexual health screen. You do not need a prescription. 

You can treat yourself at home with an insecticide cream, lotion or shampoo – such as Lyclear – bought from the chemist.

Follow the treatment instructions on the packet carefully and ask your pharmacist, doctor or nurse if you are unsure what to do.

• In most cases the treatment is applied to the affected area as well as other hairy areas of the body. Some treatments have to be applied to the whole body.
• You can rinse off some treatments after 10-15 minutes, while others are left on longer.
• Usually you need to repeat treatments after 3-7 days.
• Be careful not to get the treatment in your eyes.
• Speak to your doctor or pharmacist if the treatment doesn’t work first time.

If you have pubic lice in your eyelashes, you need to see a doctor to get the correct treatment.

Shaving off pubic hair will not get rid of the lice.

Can I still have sex?

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Avoid sex or close contact until you and your partner have completed your treatment.

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Information Review

Pubic lice: symptoms, treatment, what is dangerous

Pubic lice are parasites that live on the human body and feed on its blood. They are also called flats. The defeat of pubic lice is called pubic pediculosis, or phthiriasis. Contrary to popular belief, infection with pubic pediculosis is possible not only in an asocial environment and from people who do not observe personal hygiene. These lice and nits can be found and picked up in the most mundane places.

Contents:

• Features of pubic lice
• Where can you find pubic lice
• How can you get phthiriasis
• Symptoms of phthiriasis
• Why phthiriasis is dangerous
• Methods for combating pubic lice
• Folk remedies
• Professional products
• Things to do when treating phthiriasis
• Prophylaxis

Features of pubic lice

These insects are small in size – up to 3 mm. Females are noticeably larger than males. They have a flattened oval body that is light brown in color. Three pairs of legs are spread wide, so it seems that the width of the insect is greater than its length. Paws are long, pincer-shaped. The structure allows them to move along the hair of a triangular section. On the round hairs that grow on the head, they cannot be fixed, therefore they do not live on the head.

Like other types of lice, pubic lice have several stages in their development:

• nits are white eggs within which larvae develop; this stage takes up to a week;
• nymphs of the 1st, 2nd and 3rd stages – in 15-17 days the parasite passes through three molts and becomes sexually mature;
• adults.

More in the article “The incubation period of lice and nits”

Pubic louse lives up to 30 days. She lays about 50 eggs during her life.

Without food, the parasite lives for a day. If adverse conditions occur, the pubic louse can fall into a state of suspended animation and spend several months in it. Pubic lice can live up to two days in water. They can withstand loads up to 1 kg. For example, on the beach, in the sand, they can exist for several days.

Where can you find pubic lice

As mentioned above, pubic lice live on the hairy parts of the human body, but do not affect the entire hairline. They are attracted to areas with apocrine glands that secrete a special secret:

• pubis;
• crotch;
• anus;
• scrotum;
• armpits.

The affected areas are always covered with hair. These parasites do not live on smooth skin. The disease occurs in both men and women. Children can also become infected if they have hair on their genitals.

How you can get phthiriasis

There are several ways to spread the disease. The most susceptible to this are women and men who lead an asocial lifestyle and promiscuous sex life, as well as those who do not observe personal hygiene.

But you can also catch pubic lice through:

• clothes of a sick person;
• towels and bed linen;
• public toilets;
• beaches, solariums;
• baths, saunas, swimming pools, etc.

Even with good hygiene, no one is protected from infection, so it is important to be careful when visiting public places and interacting with potential carriers of parasites.

Symptoms of phthiriasis

Pubic lice can be seen without the use of special equipment. They are small but move pretty fast. The nits are very small, fixed at the very base of the hairs, so it can be very difficult to notice them.

In addition to visual examination, you can find out about the presence of phthiriasis by the following symptoms:

• constant itching – it occurs due to the fact that when bitten by a parasite, a substance that is an active irritant is injected under the skin;
• small blue dots in the places of bites are traces of an injected substance that prevents blood clotting;
• due to unbearable itching, a person scratches the skin, skin lesions appear up to dermatitis and eczema.

When affected by phthiriasis, a person becomes restless and irritable.

Sometimes symptoms appear even with a small amount of parasites on the body. They can not be seen due to the fact that they hide in tangled and thick curls of hair. In this case, to confirm the diagnosis, you should consult a doctor. The specialist uses the following methods for detecting parasites:

• examination under the Wood’s lamp – it allows you to see live nits, which under its fluorescent light look white, and dead ones remain gray;
• examination of the affected areas with multiple magnification on a video dermatoscope;
• slit lamp eye examination for eyelash nits.

Why phthiriasis is dangerous

Skin damaged by scratching is favorable conditions for infections to enter the body. The combed areas become infected, abscesses, boils appear on them. If untreated, the infection goes deeper into the lymphatic system. This can lead to systemic diseases, blood poisoning. Pubic lice with their saliva carry infectious diseases, such as typhus, from person to person.

Many patients experience allergic reactions. Also, phthiriasis is almost always accompanied by sexually transmitted diseases. It can be chlamydia, gonorrhea, syphilis. Pubic lice, passing from person to person, carry pathogens of these diseases in saliva. This is the most dangerous infection with pubic pediculosis.

With a very severe infestation of a person and a large number of lice, they do not have enough space to live in the groin and armpits. In this case, they can live on the eyebrows and eyelashes. With the defeat of these areas, conjunctivitis, blepharitis and other eye diseases develop.

How to deal with pubic lice

Getting rid of pubic lice is much easier than getting rid of head or body lice. The most effective way is mechanical. That is, you just need to clean all the hair from the affected area so that the parasites do not have the opportunity to live on the body. On smooth skin, they cannot move. The “fashion” for hair removal in intimate areas that has received in the past few years has significantly reduced the incidence of this disease.

For pubic lice, shave or otherwise remove hair from the infested area. It is better to remove hair on the entire body so as not to leave an opportunity for parasites to survive adverse conditions nearby. After hair removal, it is advisable to apply a pediculicide to the affected area in order to destroy nits, which, due to their small size, can hide in skin scales.

If for some reason it is impossible to use the mechanical method, then you can use folk remedies or special preparations that kill lice and nits.

Folk remedies

These are the same remedies used to kill hair or body lice and nits. The affected areas are lubricated with such means:

• vinegar solution;
• crushed cranberry gruel;
• castor oil;
• geranium oil.

All of these options are quite forgiving. They do not harm health, but for the onset of the effect they require long-term use. With a strong defeat by pubic lice, they are powerless. In addition, you will have to leave the product on the affected areas for some time to act. This is not always convenient or appropriate.

More aggressive options can be used:

• 3% hydrogen peroxide;
• boron or sulfur ointments;
• kerosene.

They must be used with great care as they may be toxic or burn the mucous membranes. In addition, they may be ineffective against nits.

Professional remedies

Phthiriasis should be treated with medication using effective remedies that work against lice and nits. These are pediculicides that kill parasites. You can use drugs based on different active ingredients: Medilis-Permifen, Medilis-Bio, Medilis-Malathion or Medilis-Super. They are available as sprays or emulsions. Each drug is accompanied by instructions for use, which must be strictly followed. Most drugs can be used by people who do not have individual intolerance. Some can be used to treat children from 5 years of age. The result will come in a few minutes or hours.

What must be done when treating phthiriasis

Pubic lice can hide not only on the body of a person, but also in his personal belongings. Therefore, during treatment, it is important to process underwear, clothes, bedding, towels. All things that can be washed should be soaked in a pediculicide solution and washed at a high temperature, and after drying, iron or steam thoroughly. Cabinets where clothes and linen are stored should be washed with a pediculicide solution. Mattresses and upholstered furniture should preferably be treated with a steam cleaner. Since lice can wait out unfavorable times in a state of suspended animation, it is necessary to do a general cleaning, wash all surfaces with an insecticide solution. This will remove insects from the home that could survive the treatment and then return to the human body.

Prevention

Anyone can develop pubic lice, regardless of their lifestyle. To reduce the likelihood of illness, it is worth taking the following measures:

• careful personal hygiene;
• not have sexual contact with strangers;
• do not use other people’s bed linen;
• do not wear other people’s clothes and underwear;
• Do not use other people’s towels.

Protect yourself as much as possible from lice in public areas. For example, you should not sit without an individual sheet or padding on the seats in the sauna or in the locker room of the pool.

After visiting a place where infection is possible, it is necessary to thoroughly wash, wash and iron clothes with a hot iron. In order to prevent, it is worth removing hair in intimate areas.

If you suspect an infestation with pubic lice, you should consult a doctor and begin treatment, preventing the insect population from multiplying. If you start the fight right away, then you can get rid of them quickly enough and without health consequences.

What do you need to know about head lice?

Pediculosis (lice) is considered one of the most common parasitic diseases among people and is a parasitism on the human body of lice that feed on his blood.

07/12/2019

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It is impossible to determine the exact indicators, since most people do not seek medical help and sanitization in specialized institutions, but cope with parasites on their own at home.

Lice are wingless insects ranging in size from 1-1.5 mm to 2-4.5 mm;

Permanent human parasites are lice that live in the hair (head louse), underwear (clothes louse) and in the hair of the pubic region (pubic louse).

Lice bites cause intense itching and, very importantly, they carry typhus and other infections (body lice).

Female lice begin to lay eggs (nits) 1-2 days after reaching puberty. Nits are white, oblong, up to 1 mm long. Live nits are shiny, firmly glued to the hair or linen, unlike dandruff, which is easily removed.

The patient has itching, scratching, yellowish-honey-colored crusts in the occipital and temporal region of the head, behind the ears indicates the need for a thorough examination of the scalp in order to detect nits and lice (head lice).

The body louse lives and lays its eggs in the folds of underwear, clothes, especially in the area of ​​the belt, collar, cuffs, sleeves, where the clothes are closest to the body. More often, the louse affects the skin of the lower back and neck, i.e. areas corresponding to the folds of clothing.

The pubic louse is firmly attached to the base of the hair, mainly on the skin of the pubis, the border parts of the abdomen and thighs. Sometimes it crawls to other areas covered with hair (armpits, chest, mustache, beard, eyelashes, eyebrows, and in children to the scalp). On the skin, in addition to scratching, bites cause characteristic bluish-bluish spots of small sizes that do not disappear with pressure. As a treatment, shaving off the hair, washing the skin with hot water and soap is recommended.

The anatomy of lice does not allow locomotion other than crawling from place to place, so lice are transmitted directly through direct contact with a sick person or care items. Lice can survive up to 3 days in water.

Infection occurs through contact in organized groups, crowded places, while living together in a family, apartment (using common combs, brushes, bedding, clothes, etc. ). Infection with pubic lice, as a rule, occurs through sexual contact, but sometimes through bedding.

For the prevention of head lice, personal hygiene is crucial: regular washing, frequent change of linen (at least once every 7 days), use of individual combs, hats, underwear, clothes, keeping hair, clothes and home clean.

If head lice are suspected, treatment can be carried out on your own, using an anti-pediculosis agent strictly in accordance with the instructions provided. If it is not advisable for people with skin diseases, allergies, children under 5 years of age to use anti-pediculosis drugs, then it is necessary to mechanically comb out lice and nits with a fine comb, and a bald haircut is possible. Simultaneously with the treatment for pediculosis, it is imperative to carry out a change of underwear and bed linen, followed by washing. All members of the family are subject to mandatory examination for pediculosis, and if pediculosis is detected and processed.