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Public lice

When to Seek Medical Care

Generally, pubic lice can be cured with an application of certain medications, but in some circumstances it may be necessary to seek a doctor's care.

  • Go to a doctor immediately if you think you may have an infection.
    • The main problem with pubic lice is that people often scratch incessantly, and this scratching can lead to a secondary bacterial infection.
    • When scratching is intense for long periods, the skin can be worn and broken.
    • If you notice a large area of redness or pus in the area, you may have a skin infection.
    • Other signs of a pubic infection include a fever , burning when you urinate, or a genital discharge.


Self-Care at Home
  • Definitive treatment comes from the following drugs:
    1. Permethrin 5% (Elimite, Acticin): Be sure to get the 5% cream formula because crabs may be resistant to the 1% liquid form (Nix).
      • Apply to affected area and leave on for 10 minutes. Rinse with warm water afterward.
      • Avoid mucous membranes, which are found at the tip of the penis and the opening of the vagina.
      • Repeat anti-lice treatment in seven to 10 days to kill nits that may have hatched.
    2. Lindane (Kwell): An alternative treatment when Elimite is not available.
      • Apply for 10 minutes then rinse with warm water.
      • Lindane should not be used on children. (Because of potential toxicity, the sale of lindane-containing products has actually been banned in the state of California.)
      • If it is used, follow the same precautions as for Elimite.
      • Repeat anti-lice treatment in seven to 10 days to kill nits that may have hatched.
    3. Malathion lotion 0.5% (Ovide) is another prescription medications that is effective against pubic lice of crabs.
  • Use over-the-counter antihistamines such as diphenhydramine (Benadryl) for itching.
  • Combing hair is important to remove eggs. A variety of combs are available commercially. They are sold in most drugstores and online.
  • Some doctors recommend trimming your pubic hair with a nonsharp electric razor in order to cut the number of lice and eggs present.

Crabs are usually spread by direct skin-to-skin intimate contact. Avoid contact with known infected people and textiles or clothing that may have been contaminated by someone who is infected with pubic lice. After treatment has been completed, ensure that all clothing and linens have been disinfected to avoid re-infection or spread of the infection to someone else in the home.


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