Treatment

• infestation needs to be confirmed by the detection of live lice/viable eggs
  • most common in young adults, as it is often acquired during sexual contact. It is important to establish whether pubic lice have been acquired in this way or not, as there may be a need to refer the individual to a genitourinary medicine clinic for screening for sexually transmitted infections
    
    
  • contact tracing over the previous 3 months is recommended
    
    
  • aqueous malathion 0.5% liquid or permethrin 5% dermal cream are recommended for application to the entire body and should be repeated after 7 days. Patients should be advised that these recommendations may differ from the instructions included in the product packaging
    
    
  • if pubic lice infestation is unresponsive to initial insecticide treatment, repeat the previous treatment with the correct technique (rather than switching to a different treatment).if insecticide resistance is suspected, switch to the alternative insecticide (malathion or permethrin)
    
    
  • advise the individual to avoid close body contact until they and any current sexual partner have been treated
    
    
  • for infestation of the eyelashes, treat the eyelashes with Vaseline ®, or an inert occlusive ophthalmic ointment (eg simple eye ointment BP), twice a day for at least three weeks. Alternatively, use a topical insecticide (a cream rinse or shampoo). An inert occlusive ophthalmic ointment should be used for people under the age of 18 years and for those who are pregnant or breast-feeding
    
    

Reference:

• (1) MeReC Bulletin (2008); 18 (4)
• (2) Primary Care Dermatological Society. Pubic Lice (Accessed 30/7/14)