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When to Call for Pubic Lice - STI

Care Advice

Pubic Lice

1. What You Should Know:
   • Pubic lice are tiny wingless insects that live only on human beings. They are also called "crabs."
   • Pubic lice are annoying but cause no serious health problems.
   • Pubic lice are spread easily. They are spread by skin-to-skin contact during sex. They cannot jump.
   • You can treat pubic lice at home.
   • Here is some care advice that should help.
2. Treatment - Shampoo Area with Nix: Buy Nix (permethrin) anti-lice creme rinse. Follow these instructions:
   • Pour about 2 ounces (60 mL) of the cream onto washed and towel-dried pubic hair. Add a little warm water to work up a lather. Be sure to work the cream into all the hair down to the roots. Also treat any hairy areas that are infected, such as the thighs, chest or armpits. Caution: do not use Nix on the eyebrows or eyelashes.
   • Leave the Nix on for a full 20 minutes (10 minutes is not long enough to kill all the lice).
   • Rinse the hair and dry it with a towel.
   • Use Nix again in 9 days to kill any nits that were missed.
   • Read and follow all package instructions and warnings carefully.
3. Treatment - Using Other Lice Shampoos:
   • There are other over-the-counter lice shampoos made using pyrethrin. Examples include A-200 Clear, R&C, Pronto, and RID. Caution: do not use Nix on the eyebrows or eyelashes.
   • If this type of shampoo is used, it must be put on dry hair.
   • You should repeat the treatment in 7 days to kill and nits that were missed.
   • Read and follow all package instructions and warnings carefully.
4. Special Treatment for Pubic Lice on Eyelashes and Eyebrows
   • If only a few lice or nits (eggs) are found, remove them. Pick them off or use a tweezers.
   • Sometimes lice and nits on the eyelashes can irritate the eyes.
   • Your doctor may recommend a petroleum ointment made just for eyes. You apply a small amount along the edge of the eyelid 2 to 4 times per day for 10 days. This loosens the nits and makes them easier to pull off.
   • Follow your doctor's instructions carefully.
   • Caution: do not use Nix (permethrin) or other anti-lice shampoo near your eyes.
5. Pregnancy and Breastfeeding: The CDC says that women who are pregnant or breastfeeding can be treated with permethrin products (Nix).
6. Sexual Contacts:
   • Sexual partners that you have had during the last month also need treatment. They still need to be treated even if they don't see any lice.
   • Do not have sex until 2 weeks after treatment. All lice and nits should be gone before you have sex again.
7. What to Expect:
   • With 2 treatments, all lice and nits should be killed.
   • If they come back, this can mean a few things. It most often means you have had another contact with an infected person. It can also mean the treatment was not left on long enough or repeated.
   • Even after treatment, itching may last for 1 to 2 weeks.
   • There are no lasting problems from having lice. They do not carry other diseases.
8. Pregnancy Test, When in Doubt:
   • If there is a chance that you might be pregnant, use a urine pregnancy test.
   • You can buy a pregnancy test at the drugstore.
   • It works best first thing in the morning.
   • Follow all package instructions.
9. Call Your Doctor If:
   • Pregnancy test is positive or you have trouble with the at-home test
   • Moving lice in pubic hair and it has been more than 6 hours since treatment
   • Pubic lice or nits come back within 1 month
   • You think you need to be seen
   • You get worse

How to Remove Dead Lice and Nits

1. What You Should Know:
   • Only live lice can transmit lice to another person. Nits (lice eggs) do not transmit lice.
   • Most nits (lice eggs) are dead after the first treatment with Nix. The others will be killed with the 2nd treatment in 9 days.
   • Removing the dead nits is not essential. However, it may help with the anti-lice treatment and most people just find the notion of having nits in their hair unpleasant.
2. Instructions:
   • Remove the dead nits and lice by combing with a special nit comb or pull them out one by one.
   • Repeat this every 2 to 3 days for 3 weeks, until you are sure all of the lice and nits are gone.
   • Wetting the hair with water makes removal easier.
   • Do not use any products that claim they loosen the nits. Here is the reason: they can interfere with the ability of Nix to stay on the hair and keep working.

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.