Pubic lice are small insects that can live in coarse hair on the body. They are transmitted via close sexual or body contact. Fever in the host and overcrowding by the lice encourages transmission.

The time from first infestation to experience of symptoms is between 5 days and several weeks.

The main symptom is severe itching in the affected area due to the body’s immune reaction to the feeding lice. It is often found that the itching is worse at night. The lice lay eggs which stick to the hair and cannot be brushed out. Pubic lice can infest any coarse hair on the body, such as moustaches, beards and underarm hair. It is important that all areas of the body are examined and treated where necessary to avoid reinfection.

The lice are treated with an insecticide available as a lotion, cream or shampoo. It is recommended that all areas of the body be treated. The treatment should be applied as directed and then repeated 3 to 7 days later to kill any lice emerging from remaining eggs. It is advisable to check that no further lice are present one week after the treatment, to ensure that reinfection does not occur. Shaving the affected area will not help as lice only need a very short length of hair to survive.

Further guidance on the treatment and management of pubic lice includes:

• National guideline on the management of Phthirus pubis infestation by the British Association of Sexual Health and HIV.
• Pubic lice by PRODIGY guidance.

Antihistamines may be given at night to help relieve the itching. Ensure all previous sexual partners are notified and treated to avoid reinfection.

The Department of Health has published a toolkit for assessing the range of competencies in skills, knowledge and attitudes required to manage sexually transmitted infections when delivering more specialised sexual health services within primary care. Click here for more information.

It is recommended that any contact with others is avoided for at least 24 hours after the first treatment.

Not a notifiable disease.

Pubic lice can spread to other areas of the body such as beard, moustache, armpit hair and scalp hair where the hair shafts are widely spaced apart e.g. in those with red hair.

Severe itching can lead to flaking of the skin and this can cause secondary infection and regional swelling of the lymph nodes, especially around the cervical area.

Pubic lice can be prevented by avoiding close and sexual contact with an infected person. Thorough treatment and eradication of the lice can also prevent transmission.

No vaccine available.

Treatments to which there is a known hypersensitivity should be avoided.

British Association for Sexual Health and HIV
www.bashh.org

NHS Direct
www.nhsdirect.nhs.uk

NHS Direct Wales
www.nhsdirect.wales.nhs.uk

BBC Health
www.bbc.co.uk/health

National Library for Health
www.library.nhs.uk

Young People’s Sexual Health website run by Central Suffolk NHS Trust
www.ypsh.net

TheSite run by YouthNet UK with advice and support for young adults
www.thesite.org

Playing Safely
www.playingsafely.co.uk

Information for young people on sexual health and life
www.likeitis.org

NAM, Aidsmap (AIDS information for patients and health professionals)
www.aidsmap.com

Brook Advisory Centre
www.brook.org.uk

Sexual Health InfoCenter
www.sexhealth.org

Society of Sexual Health Advisers
www.ssha.info

Family Planning Association
www.fpa.org.uk

Information for young gay men run by the Terrence Higgins Trust
www.ygm.org.uk

Health information relating to the National Curriculum and the National Healthy School Standard
www.wiredforhealth.gov.uk

PRODIGY guidance
www.prodigy.nhs.uk

CHIN J, ed (2000) Control of communicable diseases manual. 17th ed. Washington: American Public Health Association.

PRODIGY (2004) PRODIGY guidance – Pubic lice [on-line]. London: Department of Health.
Available at: www.prodigy.nhs.uk/guidance.asp? [Accessed 15 April 2005].

SCOTT G (2001) National guideline on the management of Phthirus pubis infestation. Clinical Effectiveness Group [on-line]. London: British Association of Sexual Health and HIV.
Available at: www.bashh.org/guidelines/2002/pubic_lice_0901b.pdf [Accessed 15 April 2005].