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Pubic lice Causes and Risks:
Pubic lice are known scientifically as Phthirius pubis. Lice infestation is a common sexually-transmitted condition and is found mostly in adolescents. Transmission generally occurs during sexual activity but can occur through physical contact with contaminated objects or clothing such as toilet seats, sheets, and blankets. Some women have acquired it while trying on swimming suits at the store.
The presence of pubic lice is heralded by moderate to severe itching ( pruritus ) in the area covered by pubic hair. This itch is frequently worse at night. Because the crab louse requires human blood to survive, it buries its head inside a pubic hair follicle. It excretes a substance into the skin that causes the itching. Sometimes the bite can cause an inflammatory skin reaction that is bluish gray in color. Although the lice do not cause a rash , the constant scratching and digging can cause the skin to become raw, and secondary infections can develop.
On close inspection , adult lice (1.2 mm in diameter) may be seen. A magnifying glass makes the lice more easily visible and will show the small egg sacs or " nits " that are attached to the pubic hairs, usually at the base. Although pubic lice appear to prefer the pubic area, they can also thrive on the eyelashes. In young children, pubic lice may be a cause of blepharitis (an eye infection) and their eyelashes should be examined with a high-powered magnifying glass for evidence of lice.
Risk factors include: - being a sexually active adolescent
- having multiple sexual partners
- having sexual contact with an infected person
- sharing bedding or clothing with an infected person
Prevention:
Avoid sexual or intimate contact with infected people. If sexually active, use safer sex behaviors to avoid getting lice . Good personal hygiene is always recommended. If possible, avoid trying on bathing suits. However, if you must, be sure to wear your underwear while trying them on. This may prevent transmission.
Symptoms:
Signs and Tests:
An examination of the external genital region typically reveals small gray-white oval eggs ( nits ) attached to the hair shaft and may reveal adult lice . Scratch marks or signs of secondary infection such as impetigo may also be noted. Adult lice may be easily identified under the microscope. Their crab-like appearance is the reason that pubic lice are referred to as "having the crabs".
Treatment:
Pubic lice are treated with a prescription drug, gamma benzene hexachloride 1% (Kwell) shampoo. Apply it to the affected area without wetting the area with water first. Thoroughly work the shampoo into the pubic hair and surrounding area for at least 5 minutes. Rinse well. Comb the pubic hair with a fine-tooth comb to remove eggs ( nits ). Applying vinegar to pubic hair before combing may help loosen nits, but the hair should be dry when applying the shampoo. A single treatment is all that is usually needed. If another treatment is recommended, it should be done 4 days to 1 week later.
Over-the-counter medications for the treatment of lice include: At the time of treatment, wash all clothing and linens in hot water. Items that cannot be washed may be sprayed with a pediculocidal spray or sealed in plastic bags and not used for 10 to 14 days. It is imperative for all sexual contacts to be treated at the same time.
People with pubic lice should be evaluated for other STDs at the time of diagnosis.
Prognosis:
Adequate treatment, including environmental cleaning, should eradicate the lice .
Complications:
Secondary infections may occur because of skin break-down from frequent scratching.
Call Your Healthcare Provider:
Call for an appointment with your health care provider if you or your sexual partner have symptoms of pubic lice (both partners should be treated at the same time). If you know that itching is caused by pubic lice, you can try over-the-counter lice treatments, and then call the health care provider if these are ineffective. Also call if symptoms persist after treatment.
This is a photomicrograph of a female pubic louse. The condition known as "crabs" is so named because of the resemblance of a pubic louse to a crab. The bodies of pubic lice are shorter and rounder than those of head lice. (Courtesy of the Centers for Disease Control.)
This is a photomicrograph of a male pubic louse. The condition known as "crabs" is so named because of the resemblance of a pubic louse to a crab. The bodies of pubic lice are shorter and rounder than those of head lice.
This photograph shows pubic lice clinging to individual hairs (the small, whitish specks). The reddish, crusted areas with scabs (excoriated areas) are caused by scratching. (Courtesy of the Cneters for Disease Control.)
This picture compares the relative size and shape of the head louse and the pubic louse.
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