Pubic Lice (Pediculosis Pubis)

Shaving the pubic area is not necessary. In the general population, it is reported that the incidence of pubic lice is decreasing with the increase in pubic hair removal habit due to the destruction of the natural habitat of the parasite |

About

• May have other associated STDs

Aetiology

• Phthirus pubis is spread by intimate contact
• Partner management needs a look-back period of time of 3 months

Clinical

• Blue macules can be observed in the pubic area.

Investigations

• Clinical diagnosis

Management

• Topical treatment should be applied to all suspected infested regions and nits removed from the hair (combing, using tweezers). Treatment should be reapplied in 7-10 days. The topical treatment is applied to all suspected infested regions: genital and anal areas, thighs, trunk, axillae, moustache and beard areas. To minimize percutaneous absorption, the skin must be cool and dry. The nits must be removed from the hair (e.g. by combing, using fine tweezers).
• Clothing, bedding, towels and other items should be machine washed (at 50°C or higher) or dry-cleaned or sealed and stored in a plastic bag for 3 days. When starting the treatment, Patients should wear clean underwear and clothing
• Follow-up examination one week after the end of treatment. The infestation is considered cleared if there is no active infestation (no presence of live lice).
• First line therapy
  • Permethrin 1% washed off after 10 mins. Repeat after 7-10 days
  • Pyrethrins with piperonyl butoxide(washed off after 10 minutes).Repeat after 7-10 days
• Second line therapy
  • Phenothrin 0.2% lotion(washed off after 2 hours).
  • Malathion0.5% lotion(washed off after 12 hours).
  • Ivermectin PO.- 200 mcg/Kg, repeat after 7 days(in severe cases, 400 mcg/Kg repeat after 7 days)

References

• European guideline for the management of pediculosis pubis