Pubic Lice – Diagnosis and Treatment
Diagnosis
Healthcare providers often diagnose pubic lice by carefully checking the pubic area for signs of tiny, moving parasitic insects (adult louse or nymphs). Itching in the genital area commonly prompts people to seek examination.
The presence of nits (lice eggs) attached to pubic hair can help confirm an infestation, even if the eggs are no longer alive.
In some cases, providers may use a magnifying glass or a fine-toothed comb to spot lice or nits more easily. They may also check other hairy areas of the body, such as the armpits, chest, beard, or eyelashes, to see if the infestation has spread.
If a person has pubic lice, healthcare providers might also suggest testing for other sexually transmitted infections, since lice are often spread through close physical contact.
Treatment
Most people begin treatment for pubic lice with over-the-counter lotions or shampoos containing 1% permethrin or pyrethrin with piperonyl butoxide.
Apply the lice-killing lotion or shampoo directly to the affected area and follow the label instructions carefully. These treatments often clear the lice.
If standard products do not work, doctors may recommend stronger treatments. Prescription choices include:
| Medication | How to Use |
|---|---|
| Prescription Topical Insecticide Lotion | Apply to affected area, leave on for 8โ12 hours, then wash off |
| Oral Antiparasitic Agent | Take as two pills in a single dose; may repeat after 10 days if needed |
For lice on eyelashes or eyebrows, avoid regular lice creams. Use a cotton swab to gently apply petroleum jelly before bed, then wash it off in the morning. Repeat this process for a few weeks as needed, taking care to avoid eye irritation.
Remove lice and their eggs (nits) with a nit comb or fingernails. If only a few remain, this may be enough. Doctors can prescribe a special topical ointment if further help is needed.
Check all hairy areas, since lice may move to untreated spots. Treat all body hair that can be affected. Shaving does not remove pubic lice.
Treatment
Use over-the-counter lotions or shampoos as directed. Sometimes, a second treatment after 7 to 10 days is needed to make sure all lice and their eggs are gone.
Steps for Self-Care:
- Wash all clothing, bedding, and towels used in the previous two days with hot water (at least 130ยฐF / 54ยฐC).
- Dry items on high heat for at least 20 minutes.
- Handle items that canโt be washed by either dry-cleaning them or sealing them in a plastic bag for two weeks.
Prevention Tips:
- Avoid sharing personal items like towels or clothing.
- Refrain from close physical contact until treatment is complete.
Getting Ready for Your Visit
Steps You Can Take
Prepare before seeing a healthcare provider by making a list. Write down how long symptoms such as itching or visible lice have been present.
Note any recent sexual activity, contact with sexual partners, or sharing of items like towels or bedding. Include any recent over-the-counter treatments you tried. Mention ongoing health conditions and medications, including supplements.
Tip: Bring a list of recent sexual partners so they can be informed about possible exposure to lice or sexually transmitted infections.
What the Provider May Do
At the appointment, the provider will examine areas where lice may be present. They may check for live lice and eggs, especially in the genital region.
The provider might also ask questions about sexual contact, previous treatments, and symptoms to help decide the best care plan.
