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Pubic lice (Phthirus pubis) are small insects. They mostly live in the genital areas of humans. In some cases, they can also be found on other areas of the body that have hair. They are most often spread through sexual contact. Pubic lice affect men and women at all levels of society all over the world. Teenagers and people in their 20s are most often affected. But children and older adults can also get pubic lice. A single insect is called a louse.
Lice have 3 different phases in their life cycle:
Nymphs and adults are parasites and must feed on human blood to survive. If a louse falls off a person, it will die within a day or two.
Pubic lice are not the same thing as head lice or body lice. These are caused by 2 different species of insect that live on other areas of the body. Head lice live on the head, eyebrows, or eyelashes. Body lice live mostly on clothing and bedding. Unlike other kinds of lice, such as body lice, pubic lice don’t spread disease.
Pubic lice spread most often through sexual contact. Less often, you may get pubic lice from other types of close contact with a person, or by touching clothing, sheets, or towels that someone with pubic lice has used. It is unlikely to get pubic lice from sitting on a toilet seat that an infected person has used. This is because lice don’t have feet that enable them to walk on a smooth surface.
Animals don’t get pubic lice, and they play no role in its spread.
You have an increased risk for pubic lice if you have sexual contact with someone who has them.
Itching of the genital area is the most common symptom caused by pubic lice. Itching of the armpits is also common.
Usually, public lice live on pubic hair in the genital area. If you look carefully, you may be able to see visible nits or crawling lice. Less commonly, they live on hair on other parts of your body. This may include legs, armpits, beard, eyebrows, eyelashes, or on your head. Usually lice on the head are head lice, not pubic lice. Pubic lice on the eyelashes may cause eye burning or irritation.
Pubic lice on the eyebrows or eyelashes of children may be a sign of sexual abuse. More often, this is caused by shared household items, such as towels, or from close contact with nongenital infestation sites on an adult.
Your healthcare provider can diagnose you by finding a pubic louse or nit in your genital area (or less commonly, in other areas). Nits and lice are sometimes large enough to see with the naked eye, but a healthcare provider may use a magnifying glass to help with diagnosis. Adult lice may be harder to see, because there may only be a few. If you have lice outside your genital area, your healthcare provider will examine them to confirm that they are pubic lice and not head or body lice.
If you have pubic lice, you may have tests for other types of sexually transmitted infections (STI). These may include tests for chlamydia and HIV. That’s because a large number of people with pubic lice also have an STI.
Public lice can be treated with a lotion or cream put on your skin. These often contain the chemical permethrin or pyrethrin. They are available as over-the-counter treatments or by a prescription. They work well when used correctly.
Follow the directions on the package of the lotion or cream. Make sure to:
Also make sure to wash any clothing, towels, or bedding used in the 3 days before your treatment. Use hot water and dry the items on the hottest setting. Or you can dry-clean the clothes. For items that can’t be washed or dry-cleaned, place them in a sealed plastic bag for 2 weeks. This will starve any remaining lice.
The treatment should work quickly. If you continue to have itchiness a week after treatment, see your healthcare provider. You may need a repeat treatment at that time.
If you have lice in your eyelashes, your treatment may be different. You’ll likely need to coat your eyelashes with petroleum jelly twice a day for about a week. This will be a prescription type of petroleum jelly that won’t irritate your eyes. This will loosen the lice and nits so you can remove them. In more severe cases, you may need another prescription treatment.
Make sure to tell your sexual partners that you have public lice. They will need to be diagnosed and treated. Tell anyone that you had sex with in the last month. Don’t have any sexual contact until you have been treated and your healthcare provider says you are lice-free.
Pubic lice on the eyelids can lead to an inflamed lining of the eye (conjunctivitis).
Excess scratching due to itching may lead to an infection. This may need to be treated with antibiotics.
Tips to help you get the most from a visit to your healthcare provider:
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