STD - Pubic Lice
- Seeking information about pubic lice, a sexually transmitted disease (STD)
- Itching of the pubic area is the main symptom.
- Pubic hair contains gray bugs (lice) 1/16-inch long, that move quickly, and are difficult to see.
- Nits (white or tan eggs) cemented to hair shafts near the skin (usually within 1/2 inch or 12 mm). Unlike dandruff or sand, nits can't be shaken off the hair shafts.
- Pubic lice are tiny wingless insects that live only on human beings.
- The primary mode of transmission is via the skin-to-skin contact that occurs during sexual intercourse. Lice are very contagious. There is a 95% chance of transmission during a single episode of sexual intercourse. Rarely they may be transmitted via objects such as infected bed linens or toilet seats.
- Pubic lice are annoying but cause no serious health problems.
- They are also referred to as "crabs."
- Up to 30 % of individuals with pubic lice also have another sexually transmitted disease.
- American Social Health Association
- "Answers to your questions about teen sexual health and sexually transmitted diseases"
- Sexually Transmitted Diseases Treatment Guidelines 2002. MMWR. 2002; 51(RR-6):1-80
- Public Health Agency of Canada.
- Sexually Transmitted Infections (STI), Sexual Health Facts and Information
When to call your doctor
Call Your Doctor Now (night or day) If
- You feel weak or very sick
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
- You think you need to be seen
- Looks infected (e.g., pus, soft scabs, open sores)
- More than 6 hours since completing treatment and moving lice are seen in the pubic hair
- Pubic lice or nits recurs within 1 month
- New or unusual vaginal discharge (e.g., odorous, yellow, green, or foamy-white)
- White or yellow discharge from penis
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
- Pubic lice
HOME CARE ADVICE FOR PUBIC LICE (PENDING TALKING WITH YOUR DOCTOR)
- NIX: Buy Nix anti-lice creme rinse (permethrin).
- Pour about 2 ounces of the creme onto previously washed and towel-dried pubic hair. Add a little warm water to work up a lather. Be sure to work the creme into all the hair down to the roots.
- Leave the Nix on for a full 20 minutes or it won't kill all the lice (10 minutes is not enough).
- Rinse the hair thoroughly and dry it with a towel. Repeat the Nix treatment in 1 week to kill any nits that were missed.
- Dead Nits: Wait 3 or more hours after Nix treatment is completed before removing the dead nits. (Reason: let Nix permeate the nits) The nits can be loosened using a mixture of half vinegar and half warm water. After wetting the hair with this solution, cover the hair with a towel for 30 minutes. Then remove the dead nits by backcombing with a special nit comb or pull them out individually.
- Pregnancy and Breastfeeding: According to the Centers for Disease Control, women who are pregnant or who are breastfeeding can be treated with products containing permethrin (e.g., NIX).
- Contagiousness: Pubic lice are very contagious. Pubic lice are transmitted by skin to skin contact during sexual intercourse (they cannot jump). You should have no sexual intercourse until 2 weeks after successful treatment.
- Sexual Contacts: Any sexual partners that you have had during the last month will also need treatment even if they don't see any obvious lice.
- Expected Course: With 2 treatments, all lice and nits should be killed. A recurrence usually means that there has been another contact with an infected person; the shampoo wasn't left on for 20 minutes; or the treatment wasn't repeated in 7 days. There are no lasting problems from having lice and they do not carry other diseases. Even after successful treatment, itching of the pubic area may persist for 1-2 weeks.
- Other Shampoos: If any of the pyrethrin anti-lice shampoos (A-200 Clear, R & C, Pronto or RID) are used, they must be applied to dry hair. Reapplication in 7 days to prevent re-infection is also required. Do not use these products if you are pregnant or breastfeeding.
- Pregnancy test, when in doubt:
- If there is any possibility of pregnancy, obtain and use a urine pregnancy test from the local drug store.
- Follow the instructions included in the package.
- STD National Hotline
- The CDC National STD Hotline provides information on sexually transmitted diseases (STDs), such as chlamydia, gonorrhea, HPV/genital warts, herpes, and HIV/AIDS. Specialists can provide general information, referrals to local clinics, and written materials about STDs and disease prevention.
- Toll-free number (English): (800) 227-8922
- Toll-free number (Spanish): (800) 344-7432
- Their website is at: http://www.ashastd.org
- Call Your Doctor If:
- Pregnancy test is positive or if you have difficulties with the home pregnancy test
- You become worse
Author: David A. Thompson, M.D.
Last reviewed: 9/15/2011
Last revised: 4/2/2009 2:40:26 PM