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What are pubic lice and body lice?

Pubic lice (with the Latin name of Phthirus pubis) are either grey or brown and are small insects, only 1–2-mm long. They are commonly called ‘crabs’ because their second and their third pairs of legs have claws that are crab-like which they use to hold tightly onto your pubic hair (and other body hair) where they live. Pubic lice are blood-sucking insects that survive through biting your skin and feeding on your blood. The female pubic lice live for 1–3 months and lay a total of around 300 very small eggs (‘nits’) in their life, eggs that are much smaller than the head of a pin.

Pubic lice prefer thicker/coarser hair and inhabit all the hairy areas except for the hair on your head, because this softer/finer hair is difficult for them to attach to. (Lice that live in the hair on your head are a different species called Pediculus humanus capitis.) Pubic lice mostly live in your pubic hair, but they may also affect the hair around your anus (your back passage), your beard, your underarms, your chest and even your eyebrows/eyelashes.

Body lice are 3–4-mm long, so they are longer than pubic lice, but have narrower bodies. The scientific name for body lice is Pediculus humanus. Also known simply as ‘clothing lice’, these body lice and eggs often inhabit the seams of clothing, and can also be found anywhere on your body, yet tend to avoid the scalp area, except at the margins of the scalp.

Your IPSA Medical pubic lice and body lice consultation

You can be assured that your IPSA Medical clinic will always uphold its key principle of total confidentiality and that IPSA Medical provides a discrete and private setting for any examinations/tests that are required. Your IPSA Medical practitioner will employ a client-centred approach during your pubic/body lice consultation. Your IPSA Medical physician is skilled and experienced at diagnosing and treating pubic/body lice and he/she will discuss the best treatment options for dealing with lice with you prior to selecting the best lice treatment plan to meet your particular needs.

How do you ‘catch’ pubic lice?

Transmission of public lice requires close bodily contact and you generally ‘catch’ these lice when having sex with a partner with a pubic lice infestation.

Pubic lice can also be transmitted from close and non-sexual but physical contact with a lice-infested individual (e.g. when kissing a bearded, lice-infested man).

As pubic lice/eggs do attach quite strongly to coarser hair, they do not simply fall off, wash off, or brush off. Pubic lice need a human host and they cannot survive for very long without feeding from their host; thus, transmission via shared clothes, towels, bed linen or from toilet seats is unlikely.

How are body lice transmitted?

These kinds of lice can be transmitted via close physical contact (and not merely through sexual contact) with a body lice-infested person. Body lice can be picked up from lice-infested clothing, bedding, or towels. Homeless people are often infested with body lice if they can’t change their clothes often enough or wash frequently.

What are the symptoms of pubic lice and body lice?

Pubic lice

The most usual/common pubic lice symptom is a general itch in the lice-affected areas (mainly your pubic hair region), taking effect 1–3 weeks after the initial exposure. As lice feed at night, the itching worsens at nighttime, and is caused by sensitivity to the saliva of the lice, with itchy and red bumps sometimes forming on your skin in the infected hair-covered areas. Where these pubic lice have been feeding, blue, faint spots might form on your skin, and because of scratching/skin irritation, redness and a rash might also develop.

If the pubic lice infest your eyelashes, eye inflammation can occur.

Sometimes, you might see tiny specs on your underwear or on your skin that have a dark-brown colour: the lice faeces.

Some people are asymptomatic (they have no symptoms) but they can still transmit pubic lice without realising it.

Body lice

Some people are asymptomatic (they have no symptoms) when they are infested with body lice, but they might notice lice (‘nits’) on their body/clothes.

It is common with body lice to itch at night, especially under your armpits, in your trunk region, or around your groin, as body lice live in/on your clothing throughout the day, moving onto your skin to feed off your blood at night.

You might also notice that you develop small blue spots and/or red lumps on your skin.

How does IPSA Medical treat lice?

Pubic lice

During your IPSA Medical pubic/body lice consultation, your IPSA Medical skin physician will assess and discuss with you the best lice treatment depending on your symptoms. The first line of defence is an insecticide treatment which kills pubic lice and is specially formulated for use on people. Your IPSA Medical clinician will explain how your entire body will require two full insecticide applications (with a 7-day break between your initial application and second application), and how none of the insecticide should get in your eyes.

Two insecticides are most usually used for pubic lice treatment: Malathion lotion (Derbac-M®, Quellada-M®) and permethrin 5% cream (Lyclear® Dermal Cream). As alcohol-based products can further irritate your skin, aqueous (or water-based) products are the preferred choice. These insecticidal lotions/creams are very easy to apply and, if you use them properly, they are usually effective.

Your IPSA Medical physician will run through the procedure for the successful application/treatment of pubic lice with you:

  • Malathion is a suitable treatment for any age group.
  • Permethrin is not usually prescribed if you are less than 18.
  • The lotion and the cream have to be applied over your entire body and scalp, as pubic lice can spread to most parts of your body, even to your scalp region. The hairier parts of your body need special attention, and you must ensure your pubic hair, your moustache, beard, eyebrows and the hair around your anus (your back passage) have a through application. Your IPSA Medical clinician will detail the application procedure and will highlight the dangers of getting any of the cream/lotion in your eyes.
  • For an adult to cover their entire body, the average dose is 20–30 grams of permethrin cream or 100 ml of Malathion lotion.
  • Your skin needs to be dry and cool when you apply your cream/lotion, so if you have had a bath/shower, you need to allow time for your skin to dry/cool down prior to applying the insecticide.
  • Leave your cream/lotion on for the stated time and then wash it off. Malathion lotion needs 12 hours to work before washing it off, whereas the permethrin cream needs 24 hours to work before washing it off.
  • If you wash, for example, your hands during the treatment period, then you need to reapply the lotion or cream to the area.
  • Shaving the affected area is not necessary; the cream/lotion clears pubic lice without shaving.
  • One precautionary measure involves washing all bedding, clothing (especially underwear), and towels from the week before any symptoms started, although the scientific evidence is not clear on whether this is an essential practice.

Your IPSA Medical skin physician will advise you on the possible pubic lice treatments if your eyelashes happen to be infected; usually, a very simple and greasy eye ointment (called Lacri-Lube®), which is somewhat like Vaseline®, is applied to your eyelashes using a cotton bud, suffocating the lice.

Some treatments might be inappropriate if you are either currently pregnant or breastfeeding; your IPSA Medical physician will discuss this at your consultation.

After the 7-day waiting period, exactly the same treatment procedure is carried out, as although your pubic lice will have been killed, some lice eggs may not have been killed with the initial insecticide application, with the second application ensuring that any hatched lice from eggs that survived the initial insecticide application are killed and can’t then lay any further eggs.

Body lice

As body lice tend to live in/on your clothing and bedding, a skin application is less critical. The main treatment protocol that your IPSA Medical doctor will suggest is targeted at destroying the body lice that are present in your clothing/bedding. This means laundering all of your clothing/bedding in very hot water (minimum 130°F), ironing everything with a hot iron, then drying everything in a hot tumble dryer or having your items dry-cleaned. If you have an extensive body lice infestation, then you may require an insecticide application onto your body.

If the body lice outbreak has occurred in a community setting, then all clothing/bedding may undergo an insecticide treatment.

Do my family/friends also need to be treated for lice?

Pubic lice

Any of your recent (within 3 months) sexual partners or close contacts need to be examined (even if they are asymptomatic) and then treated if they have a pubic lice infestation.

Body lice

Anyone who has been in contact with bedding/clothing or the body of an infected individual needs to be examined and then treated for body lice, if appropriate. Also, their clothing and bedding should be de-loused (as outlined above) and they should work to improve their own hygiene routines.

Other points applicable to pubic lice

Even after a successful insecticide treatment, itching can take several days to settle.

If your symptoms remain after your second lotion/cream treatment, then speak to your IPSA Medical skin physician because your pubic lice might be resistant to the insecticide you used and you might then need a different type of insecticide.

Avoid all close bodily contact with other people until finishing your second cream/lotion application.

If your pubic lice infestation was transmitted through sexual contact, then you need to think about being tested for other sexually transmitted infections. Your IPSA Medical physician will test you for other STIs, if appropriate.

To book your IPSA Medical pubic lice/body lice same-day consultation, simply phone IPSA Medical or book online.

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