Thanks Alice,
Itching to Know

Lice eggs (nits) are small, gray, teardrop-shaped eggs that fasten themselves onto each individual hair. The crabs actually look like mini-crabs, and cause intense itching. Effective, over-the-counter treatments for pubic lice are available at drugstores even though they are used primarily for head lice (read the label for products gentle enough to use on pubic hair and genitals). Look for medications that are 1 percent permethrin creme rinses since they're milder than prescription medications. Shampoo the product into pubic and surrounding body hair and skin as directed. For men, avoid applying the treatment to the tip of the penis. For women, avoid contact with the exposed mucous membranes of the vagina. Another application, after seven to ten days, may be necessary.

However, if the itching continues to be a nuisance after treatment has been completed, something else may be "bugging" you down there. Skin in and around the genital region is generally more sensitive than skin of more exposed areas, such as the arms and legs. You may be experiencing an allergic reaction to lotions, creams, perfumes, or soaps. Try using a different lotion, cream, or soap, preferably ones without perfumes and dyes, since these are better for sensitive skin. Remember that you may need to try several different brands until you find the one that is right for you.

Another cause could be dry skin. Since pubic lice are very small in size (up to two millimeters), small skin flakes may be mistaken for pubic lice. In this case, use an emollient, sensitive skin formula lotion or cream after you shower and before you go to bed until the skin is no longer dry, scaly, and itchy. Also, try a moisturizing cleansing bar rather than soap, and warm rather than hot water, both of which will be less drying to your skin.

However, if none of these recommendations works well or adequately, see a health care provider so that s/he can examine you and determine appropriate treatment(s).

How do you know you're better? Sometimes, the absence of itching is not the best indicator. Itching may still continue after completed and successful treatment because some eggs and lice may remain attached to pubic hair. These lice and eggs, now dead, infertile, or incapable of hatching, irritate the underlying genital skin, causing the continued itchiness and discomfort. If this turns out to be a problem you would like to resolve sooner than waiting for the affected pubic hairs to fall out, you could remove the eggs and lice manually, but this can be a tedious process (Alice has heard of professional "nit-pickers" out there who handle these annoying problems, and aren't annoying themselves!). Use a fine-tooth comb or your thumb and forefinger, guiding the eggs off each hair and dispensing of them in a tissue. Or, if you prefer, you can trim the affected pubic hairs, or go as far as shaving all hair from the genital region, depending on what makes you more comfortable. Be sure to do this properly to avoid infection.

For others, the itchiness remains because people experience psychological reactions to having had pubic lice. They may feel itchy because they are uncomfortable about having been infested, or because they may have gotten pubic lice from sleeping with someone who they did not consider clean or hygienic. If this turns out to be your problem, and remains a problem for you, then contact Health Services at Columbia at x4-2284 for information on what to do to help you regain peace of mind (and body).

About modes of transmission, pubic lice is most commonly spread through sexual contact. However, it can also be transmitted by direct nonsexual contact with someone who has lice, or with that person's clothing, bedding, furniture, and other personal belongings. Although you have not had sex during the past several months, any close body contact, whether or not it involved any kind of sexual activity, with someone who has lice could have given you pubic lice. Pubic lice is not limited to pubic hair — it can also be found on other hairy parts of the body. The reasons for close body contact transmission are that the typical life (egg-to-egg) cycle of pubic lice averages approximately three weeks, and that an untreated, infested individual is contagious as long as pubic lice or eggs remain alive. Although less likely, because pubic lice live for only two days when off of a host, if you have been living with someone or know someone who has pubic lice (whether or not you are aware of her/his condition), you may have been the unlucky recipient of pubic lice via contact with an infested individual's personal belongings.

To help stop the spread of pubic lice and eggs, wash affected clothes and bedding in water that is at least 140 degrees Fahrenheit (60 degrees Celsius... hot water cycle), or put them in a sealed plastic bag for two weeks. Sexual partners, roommates, and family members who have been exposed need to take the same treatment steps.

For more information, read the Related Q&As listed below.

And let these annoying little critters know that they should bug off!

Alice

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