Pubic lice

Alternative names:

crabs; lice - pubic; pediculosis

Definition:

A six-legged louse which may invade the pubic hair region and infest it with their eggs. These lice can also infest axillary hair and eyebrows, but they are drawn to the pubic region. Pubic lice infestation, or crabs, is considered a sexually-transmitted disease.

Causes, incidence, and risk factors:

Pubic lice are known scientifically as Phthirius pubis. Lice infestation is a common sexually-transmitted condition and is found mostly in adolescents. Transmission generally occurs during sexual activity but can occur through physical contact with contaminated objects or clothing such as toilet seats, sheets, and blankets. Some women have acquired it while trying on swimming suits at the store.

The presence of pubic lice is heralded by moderate to severe itching (pruritus) in the area covered by pubic hair. This itch is frequently worse at night. Because the crab louse requires human blood to survive, it buries its head inside a pubic hair follicle. It excretes a substance into the skin that causes the itching. Sometimes the bite can cause an inflammatory skin reaction that is bluish gray in color. Although the lice do not cause a rash, the constant scratching and digging can cause the skin to become raw, and secondary infections can develop.

On close inspection, adult lice (1.2 mm in diameter) may be seen. A magnifying glass makes the lice more easily visible and will show the small egg sacs or "nits" that are attached to the pubic hairs, usually at the base. Although pubic lice appear to prefer the pubic area, they can also thrive on the eyelashes. In young children, pubic lice may be a cause of blepharitis (an eye infection) and their eyelashes should be examined with a high-powered magnifying glass for evidence of lice.

Risk factors include:

• being a sexually active adolescent
• having multiple sexual partners
• having sexual contact with an infected person
• sharing bedding or clothing with an infected person