What is the treatment for pediculosis (crab lice)?

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Last updated: March 7, 2025View editorial policy

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From the Research

For crab lice (pubic lice) treatment, I recommend permethrin 1% cream rinse as the first-line treatment, as it is the most effective and safest option available, with a high success rate in eliminating the infestation and improving quality of life. The provided evidence does not directly address the treatment of pediculosis (crab lice), but based on general medical knowledge, permethrin 1% cream rinse is the recommended treatment. Apply it to all affected areas, leave on for 10 minutes, then rinse off thoroughly. A second application 7-10 days later is necessary to kill newly hatched lice. Alternatively, pyrethrin with piperonyl butoxide can be used following the same protocol. For severe or resistant cases, oral ivermectin 250 μg/kg as a single dose, repeated after 7 days, is effective. All clothing, bedding, and towels should be washed in hot water (at least 130°F) and dried on high heat to kill any remaining lice or eggs. Sexual partners from the previous month should be treated simultaneously to prevent reinfection. These treatments work by attacking the nervous system of the lice, causing paralysis and death. It's essential to treat promptly as pubic lice can cause intense itching and secondary skin infections if left untreated. Complete eradication typically requires both proper medication application and thorough environmental cleaning.

Some key points to consider when treating pediculosis include:

  • The importance of treating all affected areas and sexual partners to prevent reinfection
  • The need for a second application of treatment 7-10 days after the initial application to kill newly hatched lice
  • The use of oral ivermectin for severe or resistant cases
  • The importance of washing and drying clothing, bedding, and towels in hot water to kill any remaining lice or eggs
  • The potential for secondary skin infections if left untreated, highlighting the need for prompt treatment to improve quality of life and reduce morbidity.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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