What is the treatment for pediculosis pubis (pubic lice)?

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From the Guidelines

Pediculosis pubis, also known as pubic lice, can be effectively treated with pyrethrins with piperonyl butoxide applied to the affected area and washed off after 10 minutes. This treatment is based on the guidelines from the Centers for Disease Control and Prevention, as outlined in the 1993 sexually transmitted diseases treatment guidelines 1.

Key Treatment Points

  • Apply pyrethrins with piperonyl butoxide to all affected areas, including pubic hair, underarms, and other body hair where lice may be present
  • Leave the medication on for the recommended time, usually 10 minutes, before rinsing thoroughly
  • A second treatment may be necessary 7-10 days later to kill any newly hatched lice
  • In addition to medication, it is essential to wash all clothing, bedding, and towels in hot water and dry on high heat to kill any remaining lice or eggs
  • Sexual partners from the past month should also be treated simultaneously to prevent reinfestation

Additional Considerations

  • The treatment works by paralyzing the nervous system of the lice, causing their death
  • It is crucial to follow the treatment guidelines carefully to ensure effective elimination of the lice and prevent reinfestation
  • In cases of severe infestations or treatment failures, alternative treatments may be necessary, but pyrethrins with piperonyl butoxide remains the recommended initial treatment 1.

From the FDA Drug Label

For the treatment of Head Lice, Pubic (Crab) Lice and Body Lice PUBIC (CRAB) LICE pubic (crab) lice may be contracted by sexual contact sexual partners should be treated simultaneously to avoid reinfestation Treat apply thoroughly to dry hair or other affected area.

The treatment for pediculosis pubis (pubic lice) is to apply pyrethrin shampoo thoroughly to the dry affected area. A second treatment must be done in 7-10 days to kill any newly hatched lice eggs (nits). Sexual partners should be treated simultaneously to avoid reinfestation 2.

From the Research

Treatment Options for Pediculosis Pubis

The treatment for pediculosis pubis, also known as pubic lice, typically involves the use of topical pediculicides. The following are some of the recommended treatment options:

  • First-line therapy: permethrin or pyrethrins with piperonyl butoxide 3, 4, 5
  • Second-line therapy: phenothrin, malathion, and oral ivermectin 3, 6
  • Traditional treatments: hand-picking and combing, although these methods may not be as effective as pediculicidal products 6

Importance of Partner Management

It is essential to treat sexual contacts to prevent the spread of pubic lice 7, 3. A look-back period of 3 months is recommended for partner management 3.

Diagnosis and Prevention

Diagnosis of pediculosis pubis is usually clinical, and screening for other sexually transmitted infections (STIs) is indicated 7. The presence of pubic lice should prompt an evaluation for STIs in adults 4, 5. Extensive environmental decontamination is not necessary after pediculosis is diagnosed 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

European guideline for the management of pediculosis pubis.

Journal of the European Academy of Dermatology and Venereology : JEADV, 2017

Research

Pediculosis and scabies.

American family physician, 2004

Research

Lice and Scabies: Treatment Update.

American family physician, 2019

Research

A clinical review and history of pubic lice.

Clinical and experimental dermatology, 2021

Research

European guideline for the management of pediculosis pubis, 2010.

International journal of STD & AIDS, 2011

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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