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Crabs/Pubic Lice


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Adult pubic lice are 1.1-1.8 mm in length.
Pubic lice typically are found attached to hair in the pubic area but sometimes
are found on coarse hair elsewhere on the body (for example, eyebrows,
eyelashes, beard, mustache, chest, armpits, etc.).

Pubic lice infestations (pthiriasis) are
usually spread through sexual contact. Dogs, cats, and other pets do not play a
role in the transmission of human lice.

Both over-the-counter and prescription
medications are available for treatment of pubic lice infestations.

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Crabs/Pubic Lice

  1. 1. Fitango Education Health Topics Crabs/Pubic Lice
  2. 2. OverviewAdult pubic lice are 1.1-1.8 mm in length.Pubic lice typically are found attached to hair in thepubic area but sometimesare found on coarse hair elsewhere on the body(for example, eyebrows, 1
  3. 3. Overvieweyelashes, beard, mustache, chest, armpits, etc.).Pubic lice infestations (pthiriasis) areusually spread through sexual contact. Dogs, cats,and other pets do not play arole in the transmission of human lice. 2
  4. 4. OverviewBoth over-the-counter and prescriptionmedications are available for treatment of pubiclice infestations. 3
  5. 5. DiagnosisPubic lice are short and crab-like andappear very different from head and body lice.Pubic lice infestation isdiagnosed by finding a “crab” louse or eggs on hairin the pubic region or, 4
  6. 6. Diagnosisless commonly, elsewhere on the body (eyebrows,eyelashes, beard, mustache,armpit, perianal area, groin, trunk, scalp). Althoughpubic lice and nits canbe large enough to be seen with the naked eye, amagnifying lens may benecessary to find lice or eggs. 5
  7. 7. TreatmentA lice-killing lotion containing 1%permethrin or a mousse containing pyrethrins andpiperonyl butoxide can be usedto treat pubic ("crab") lice. These products areavailable 6
  8. 8. Treatmentover-the-counter without a prescription at a localdrug store or pharmacy.These medications are safe and effective whenused exactly according to theinstructions in the package or on the label.Lindane shampoo is a prescription 7
  9. 9. Treatmentmedication that can kill lice and lice eggs. However,lindane is notrecommended as a first-line therapy. Lindane canbe toxic to the brain andother parts of the nervous system; its use shouldbe restricted to patients who 8
  10. 10. Treatmenthave failed treatment with or cannot tolerateother medications that pose lessrisk. Lindane should not be used to treatpremature infants, persons with aseizure disorder, women who are pregnant orbreast-feeding, persons who have 9
  11. 11. Treatmentvery irritated skin or sores where the lindane willbe applied, infants,children, the elderly, and persons who weigh lessthan 110 pounds.Malathion* lotion 0.5% (Ovide*) is aprescription medication that can kill lice and somelice eggs; however, 10
  12. 12. Treatmentmalathion lotion (Ovide*) currently has not beenapproved by the U.S. Food andDrug Administration (FDA) for treatment of pubic("crab") lice.Ivermectin has been used successfully totreat lice; however, ivermectin currently has notbeen approved by the U.S. 11
  13. 13. TreatmentFood and Drug Administration (FDA) for treatmentof lice.How to treat pubic lice infestations: (Warning:See special instructions for treatment of lice andnits on eyebrows oreyelashes. The lice medications described in thissection should not be used 12
  14. 14. Treatmentnear the eyes.)-- Wash the infested area; towel dry.-- Carefully follow the instructions in thepackage or on the label. Thoroughly saturate thepubic hair and other infested 13
  15. 15. Treatmentareas with lice medication. Leave medication onhair for the time recommendedin the instructions. After waiting therecommended time, remove the medicationby following carefully the instructions on the labelor in the box.-- Following treatment, most nits will still 14
  16. 16. Treatmentbe attached to hair shafts. Nits may be removedwith fingernails or by using afine-toothed comb.-- Put on clean underwear and clothing aftertreatment.-- To kill any lice or nits remaining on 15
  17. 17. Treatmentclothing, towels, or bedding, machine-wash andmachine-dry those items that theinfested person used during the 2-3 days beforetreatment. Use hot water (atleast 130°F) and the hot dryer cycle.-- Items that cannot be laundered can be 16
  18. 18. Treatmentdry-cleaned or stored in a sealed plastic bag for 2weeks.-- All sex partners from within the previousmonth should be informed that they are at risk forinfestation and should betreated. 17
  19. 19. Treatment-- Persons should avoid sexual contact withtheir sex partner(s) until both they and theirpartners have been successfullytreated and reevaluated to rule out persistentinfestation.-- Repeat treatment in 9-10 days if live lice 18
  20. 20. Treatmentare still found.-- Persons with pubic lice should be evaluatedfor other sexually transmitted diseases (STDs).Special instructions for treatment of liceand nits found on eyebrows or eyelashes: 19
  21. 21. TreatmentIf only a few live lice and nits arepresent, it may be possible to remove these withfingernails or a nit comb.If additional treatment is needed for liceor nits on the eyelashes, careful application ofophthalmic-grade petrolatum 20
  22. 22. Treatmentointment (only available by prescription) to theeyelid margins 2-4 times a dayfor 10 days is effective. Regular petrolatum (e.g.,Vaseline)* should not beused because it can irritate the eyes if applied. 21