Pediculosis pubis or Pubic lice is the infection of the genital region. Pubic lice caused by the parasite known as crab louse. Scientifically crab louse is known as Phthirus pubis. Pubic lice commonly called crabs are tiny bugs are visible to the naked eye and no visual aid such as a magnifying glass or microscope is required. Pubic lice dwell on pubic hair or hair in any other part of the body and causes itching where they live.
As soon as a person experiences pruritus and notices lice or nits on their pubic hair, they must seek medical attention as they might be suffering from pediculosis pubis (i.e., pubic lice). Pubic Lice is generally spread through sexual contact.
Although Pediculosis pubis is a very embarrassing disease it can be totally cured. Generally Permethrin is applied for the treatment of pubic lice. 1% permethrin cream rinse is applied in the infected part and after 10 minutes it is washed off. Alternatively lindane shampoo and pyrethrins are also used for treating pubic lice. 1% shampoo of lindane applied to the infected area and washed off after four minutes. Pyrethrins with piperonyl butoxide applied to the infected region for 10 minutes before washing off. Malathion and Ivermectin are also used sometimes. Malathion 0.5% lotion applied for 8 to 12 hours and washed off and Ivermectin 250 ug/kg repeated in 2 weeks.
Now the pubic lice have begun to develop resistance against the treatment. Reports of pediculcides resistance are increasing and are widespread. When it is believed that treatment failure has occurred due to resistance, Malathion is used for treatment. The odor and long duration of application is what has made Malathion an infamous and less attractive alternative for treatment than the recommended ones. Ivermectin has been found successful in treating pubic lice but has been only evaluated in small studies.
Because of its toxicity Lindane is not prescribed as first-line therapy. It is used as an alternative where the others have failed or the patient is unable to tolerate other therapies. Though usually not used for its toxicity, but if treatment is limited to the recommended 4-minute period it seldom affects the patient. Lindane toxicity, as indicated by seizure and aplastic anemia are not reported if applied for the recommended time period. Permethrin is also found toxic though it’s less toxic than Lindane.
None of these treatments should be used near the eyes as they are very irritating. A patient’s bedding and clothing should be machine-washed with hot water to kill all the germs and infection present in there. All sexual partners that the patient had intercourse with in the previous month should be examined for pubic lice and other STDs and treated accordingly.