Diseases
   


Phthirus pubis, 'Crabs', 'Pubic Lice'

What is it?
The official name is Phthirus pubis, ("CRABS" or pubic lice) are parasitic insects generally found in the genital area on pubic hair. They are sometimes found on other coarse body hair, such as leg hair, stomach or anal hair, armpit hair, mustache, beard, eyebrows, and eyelashes. Animals do not generally get or spread pubic lice.

Symptoms
People with pubic lice often have intense itching or they notice the lice or nits (lice eggs) on their pubic hair. The itching usually begins within one week of being infested, but if you have had them before and are already sensitized to them, the itching begins almost immediately. You can also see the lice (they are pale gray but darken in color when swollen with blood) and nits (they are white and are deposited in small clumps near the hair roots) with a magnify glass. The pubic lice are typically 1mm in length. It is easier to see the nits on the hair than it is to see the actual lice. Pubic lice are like a lot of other STDs - you may be infected and have no signs or symptoms.

Of particular concern to women
Pubic lice don't need penetrative sex to spread. Women who have sex with women can still be at risk.

How do you get it?
Pubic lice are usually spread through close physical contact. Sex is the most common means of infestation. Lice must come into physical contact with body hair. They also need regular blood meals from their host, so they rarely survive more than 24 hours off the body. Lice can spread with non-penetrative sex and possibly, but rarely, through contact with an infested person's bed linens, towels, or clothes. Infestation through toilet seats is very unlikely.

Treatment
It is easy to get treatment for pubic lice. Some common preparations available are Kwell and Nix. These can be purchased at a pharmacy without a doctor's prescription. The pharmacist can also be very helpful in advising you what treatment would be best. It is important to follow the instructions that come with the product. If you are concerned about allergies, sensitivities, are pregnant/breastfeeding or are treating a young child, it may be best to see a doctor before beginning treatment. You need to consult a doctor if you have lice on the eyebrows or eyelashes because the standard treatment cannot be used around the eyes.

It is good to use a "nit" comb to remove the remaining eggs (you can use your fingernails if you don't have one). A good trick is to comb the infected hair and wipe it on a tissue and observe the crabs, if they are not moving this is good as it means the bugs are not resistant to the medication. If they are still moving, it may be a good idea to try another brand of medication, with a different active ingredient.

It isn't necessary to decontaminate the entire house. Since the lice can live off the body for only a short period of time (1-2 days), it is recommended you machine wash any item used in the past 2-3 days (e.g. clothes, bedding etc.). Use the hot cycle for the washing machine and dryer. If an item cannot be machine washed, get it dry-cleaned. If you do not have access to a washing machine or drycleaners, make sure that a potentially infected item of clothing does not have contact with your body for 72 hours.

You may need to treat again in 7-10 days if lice are found, but remember that it takes a few days for the itchiness to disappear. Since some people infected with pubic lice may not have any symptoms, they may not get treated. It would be a good idea to make sure that all your sexual partners are informed and treated as well.



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