Pubic Lice/Crabs

When to See a Doctor

While pubic lice can often be treated with over-the-counter medications, there are situations where seeking medical advice is necessary. Consulting a healthcare professional ensures proper diagnosis and effective management, especially in cases with complications or uncertainties. 

Signs to see a doctor:

1. Uncertainty about the diagnosis. If you suspect an infestation but are unsure, a doctor can confirm the presence of pubic lice and rule out other conditions with similar symptoms, such as scabies or dermatitis.
2. Failure of over-the-counter treatments. If symptoms persist or lice remain after completing an over-the-counter treatment, a doctor may prescribe stronger medications or alternative therapies.
3. Signs of secondary infection. Intense scratching can lead to skin infections, indicated by redness, swelling, pain, or pus. These infections require prompt medical attention and possibly antibiotics.
4. Infestation in unusual areas. If lice are found on the eyelashes, eyebrows, or other sensitive areas, specialized treatment is needed, as standard treatments may not be safe for these regions.
5. Multiple infestations or reinfestation. If the lice return after treatment or if there are signs of widespread infestation, a healthcare provider can help identify underlying causes or prevent further spread.
6. Concerns about sexually transmitted infections (STIs). Because pubic lice are commonly spread through sexual contact, it’s advisable to get tested for STIs if you have been exposed to or diagnosed with pubic lice.

Seeking medical advice in these situations ensures proper care and prevents complications. Early intervention and following the doctor’s recommendations help resolve the condition quickly and reduce the risk of reinfestation.

What Type of Doctor to Seek

If you suspect you have pubic lice, the first point of contact can be your primary care physician or family doctor. These general practitioners can diagnose the condition through a physical examination and recommend appropriate treatments, such as over-the-counter or prescription medications. They can also provide advice on hygiene practices and steps to prevent reinfestation or transmission to others.

In cases where complications arise or if the infestation affects sensitive areas like the eyelashes or eyebrows, you may need to consult a dermatologist. Dermatologists specialize in skin and hair conditions and are equipped to handle persistent or severe cases of pubic lice. Additionally, if the infestation was acquired through sexual contact, it may be helpful to see a sexual health specialist to address concerns about sexually transmitted infections (STIs) that could co-occur with pubic lice. Collaborating with these specialists ensures comprehensive care and effective management of the condition.

What to Expect from Your Visit to a Doctor

When you visit a doctor for pubic lice, the appointment will begin with a discussion of your symptoms, such as itching, irritation, or visible lice or nits. The doctor will ask about recent physical or sexual contact and any treatments you’ve already tried. They will then perform a physical examination of the affected areas to confirm the presence of lice or nits. For sensitive areas like eyelashes or eyebrows, they may use magnification tools for a closer inspection.

Once the diagnosis is confirmed, the doctor will recommend a treatment plan, which may include topical medications, oral treatments, or specific care for lice in delicate regions. They will also provide instructions on cleaning personal items like clothing and bedding to prevent reinfestation. If needed, they may suggest STI testing as a precaution. By the end of the visit, you’ll have a clear plan for treating the infestation and preventing its spread.

Pubic Lice/Crabs Treatment Options

Treating pubic lice (crabs) is straightforward, with various effective options available to eliminate the infestation. These treatments, which include over-the-counter and prescription medications, focus on killing both lice and their eggs. Proper hygiene and follow-up steps are also crucial to ensure complete eradication. Below are the common treatments and recommended practices for managing pubic lice:

Medications to eliminate pubic lice:

Image Source: www.freepik.com

1. Permethrin, pyrethrin, and piperonyl butoxide. These over-the-counter treatments are highly effective in killing lice in the pubic area. They are safe when used as directed and are often the first-line treatment for pubic lice infestations.
2. Lindane shampoo. This prescription-only medication kills lice and their eggs but is not recommended as a first treatment due to its potential toxicity. It should only be used under a doctor’s supervision and is unsuitable for children, pregnant women, or individuals with sensitive skin.
3. Malathion lotion 0.5% (Ovide). This prescription treatment is effective against lice and their eggs. However, it is not currently FDA-approved for pubic lice in the United States and should only be used under medical guidance.
4. Ivermectin (topical and oral). While primarily used to treat scabies, ivermectin has been proven effective against pubic lice. The oral form is not yet FDA-approved for lice treatment in the U.S. but may be prescribed in some cases.

Steps to support the treatment process:

1. Clean the affected area thoroughly. Wash the pubic area with soap and water and dry it with a clean towel before applying any medication.
2. Follow medication instructions carefully. Apply the treatment to the entire affected area and leave it on for the recommended duration as advised by the product or your doctor.
3. Remove any remaining nits. After treatment, some nits may remain attached to the hair. Use your nails or a fine-toothed comb to remove them manually.
4. Wear clean clothes and underwear. After treating the affected area, put on freshly washed and dried garments to avoid reinfestation.
5. Disinfect personal items. Wash clothes, towels, and bedding in hot water and dry them on high heat. Items that cannot be washed should be sealed in a plastic bag for two weeks to kill remaining lice and nits.
6. Repeat treatment if necessary. If lice or eggs persist after the first treatment, reapply the medication 9–10 days later or as directed by your doctor.

Proper hygiene and adherence to treatment instructions are key to successfully eliminating pubic lice. By combining effective medication with thorough cleaning practices, individuals can ensure complete removal of lice and prevent reinfestation.

Pubic Lice/Crabs Prognosis

The prognosis for pubic lice is excellent with proper treatment. Most infestations can be resolved effectively using the appropriate medications and hygiene practices. However, adherence to treatment instructions and follow-up care is essential to prevent reinfestation. Below is an overview of the expected outcomes for each treatment option:

1. Permethrin, pyrethrin, and piperonyl butoxide. These over-the-counter treatments are highly effective when used as directed, with most infestations resolving after one or two applications. They are safe and reliable for mild to moderate cases.
2. Lindane shampoo. This prescription medication works well for killing lice and their eggs in cases where over-the-counter treatments are ineffective. However, due to its potential toxicity, it is reserved for more severe or resistant infestations.
3. Malathion lotion 0.5% (Ovide). Though not FDA-approved for pubic lice, this prescription treatment can be effective in eliminating lice and their eggs. Its use is limited and should only be prescribed by a doctor.
4. Ivermectin (topical and oral). This treatment is effective for resistant cases or when other options are unsuitable. It offers a high success rate but may require close medical supervision for oral administration.
5. Hygiene and environmental measures. Washing clothes, bedding, and towels in hot water, along with manually removing nits, ensures that lice are completely eradicated and reduces the risk of reinfestation.

With the right treatment and attention to hygiene, pubic lice can be eliminated quickly and effectively. Following up on the treatment process and ensuring that all close contacts are treated helps prevent recurrence and allows for a full recovery.