If you think you have pubic lice you can consult a GP or Practice nurse, or go to a sexual health clinic, also known as a genitourinary medicine (GUM) clinic.
Pubic lice are usually easy to diagnose by examining the affected area. The doctor or nurse may use a magnifying glass to look for signs of the lice, such as pale-coloured eggs or the lice themselves.
Pubic lice are treated with insecticide cream, lotion or shampoo. Your doctor or pharmacist will advise you about which treatment is best to use and will explain how to how to use it. It is important to follow this advice.
There are different treatments:
- Those that are applied to the affected area only
- Those that are applied to the whole body
It is important to take care to avoid the eyes. Treatment will usually need to be repeated after a few days (three to seven).
Pubic lice can develop resistance to some treatments so if the treatment is unsuccessful, you may need to use another type. Your doctor or pharmacist will be able to advise you about suitable alternatives.
It is important to prevent re-infestation, so treatment should be offered to anyone you’ve had close bodily contact with, including any sexual partners you’ve had in the past three months – even if they symptom-free. If you prefer, staff at the clinic can contact a person on your behalf without releasing your details.
Certain groups may require a specific type of treatment, such as young people aged under 18 years, pregnant or breastfeeding women. Ask your doctor or pharmacist if you need advice about this.
Applying the treatment
Most lotions, creams or shampoos have the following instructions:
- apply the product to the affected area according to the instructions especially any hairy areas e.g. eyebrows, beard or moustache – some products require you to apply it to your whole body, including the scalp, neck, ears and face
- avoid getting it into your eyes –rinse thoroughly with water if you do
- the treatment will need to be reapplied according to product instructions
- passed, wash the lotion or cream off after the treatment time (according to product instructions)
- repeat the treatment as instructed
If you think it hasn’t worked consult your GP or pharmacist for advice. You should not use the medication more than twice.
The insecticides used to treat pubic lice may cause skin irritation, such as itchiness, burning, stinging or redness. If this happens, wash the insecticide off the affected area.
Some products may discolour bleached, permed, or coloured hair. Read at the patient information leaflet before applying.
The first treatment application should kill the lice however the eggs may not have been destroyed. This means more lice could hatch and the cycle will start again.
Reapplication of the treatment after three or seven days should ensure that any remaining lice are killed before they are mature enough to lay eggs.
A week after your second treatment you can check for lice or return to your GP, practice nurse, or sexual health clinic so they can check for you.
Empty eggshells (dead nits) can remain stuck to the hairs even after treatment so finding them does not mean that you are still infested.
Treating an eyelash infestation
Eyelash infestations are rare; if infested you should get specialist advice from your doctor. They’ll be able to recommend the correct treatment for you.
You cannot use the same insecticide lotion or cream that’s used for the body as it can irritate eyes. It is important to follow the treatment instructions carefully.
Washing clothing, towels and bedding
To kill lice and to prevent further infection wash clothing, towels and bedding in a washing machine. This should be on a hot cycle (50C or higher)
Sometimes, minor complications can result from pubic lice infestation, such as skin or eye problems.
Scratching may irritate the skin, or lead to an infection such as impetigo (a bacterial skin infection) or furunculosis (boils on the skin).
Eye infections, such as conjunctivitis, and eye inflammation, such as blepharitis, can sometimes develop if your eyelashes have been infested.
You must medical advice if you have severe skin irritation or sore eyes.