DERM 04 and 05: Pubic Lice

Question 1

Describe the method of transmission of pubic lice infestations.

Answer 1

• most common in 15-40 years old
• transmitted by close physical contact, sexual contact
• may be associated with coexisting STIs

Question 2

What are the signs and symptoms of pubic lice infestations? (5)

Answer 2

• pruritis in pubic area – nits attach to pubic hair
• bluish macules in pubic area
• louse excretions show as reddish brown dots
• excoriations
• may also affect eyelashes, eyebrows, other facial hair, thighs, trunk

Question 3

Who should be treated for pubic lice infestations?

Answer 3

• identify sexual partners from previous 1-3 months and treat sexual partner only if infested
• refer to physician to evaluate for concurrent STIs

Question 4

What are the non-pharmacological treatments for pubic lice infestations?

Answer 4

• clean – machine wash underwear/towels/bedsheets (if in contact with patient within past 24 hours of detection) in hot water, dry in hot dryer for at least 20 mins or store in sealed bag for 2 weeks
• if pubic lice present in eyelashes, occlusive non-medicated eye ointment (Lacrilube) can be applied to lashes BID for 10 days
• removal of lice and nits with forceps or tweezers prior to application is recommended

Question 5

What is the pharmacological treatment for pubic lice infestations?

Answer 5

• similar to head lice products and instructions
• permethrin 1% cream rinse OR pyrethrins with piperonyl butoxide shampoo
• dimethicone not tested