How it manifests itself
The main complaint is itching in the pubic and groin area, which intensifies at night, when the parasites are most active. Scratches, sometimes small crusts, as well as characteristic bluish-gray spots with a diameter of several millimeters are visible on the skin - a trace of a reaction to the insect’s saliva. Small dark spots may remain on the laundry. Upon careful examination, lice themselves are visible at the base of the hair, firmly attached to the skin, and nits - oval eggs glued to the hair. Sometimes parasites are found on eyelashes and eyebrows, more often in children.
- Itching in the groin, worse at night
- Scratching and scabs
- Bluish spots at bite sites
- Dark spots on underwear
- Nits at the base of the hair
- Damage to eyelashes and eyebrows in children
How is it transmitted?
Most often, infection occurs through close bodily contact, primarily sexual contact, therefore phthiriasis is classified as an infection associated with sexual transmission. The everyday route is also possible - through bed linen, towels, clothes, if they were used soon after the patient: the parasite does not live long outside the body. Infection through toilet seats is almost impossible. The detection of pubic lice in a child requires special attention from a doctor, because it can indicate both everyday contact in the family and other circumstances.
- Close physical, often sexual contact
- Shared bed linen and towels
- General clothing
- The parasite does not survive long outside the body
- Cases in children require separate assessment by a doctor
Diagnostics
The diagnosis is made during examination: the doctor examines the hairy areas of the body with magnification and detects mobile parasites or tightly glued nits. It is important to examine not only the pubis, but also the abdomen, chest, armpits, thighs, beard and eyelashes. Since phthiriasis is usually sexually transmitted, screening for other infections is routinely recommended: syphilis, HIV, and, if indicated, gonorrhea, chlamydia, trichomoniasis and hepatitis. Both partners undergo this examination, even if there are no complaints.
- Inspection of hairy areas with magnification
- Search for lice and nits
- Examination of eyelashes and eyebrows
- Test for syphilis
- HIV test
- Screening for other STIs according to indications
Treatment
External antiparasitic agents are used in the form of lotions, creams or shampoos, which are applied to the affected areas according to the instructions and must be repeated after 7-10 days to destroy the parasites that have hatched from the nits. It is not necessary to shave the hair, although it makes processing easier. After treatment, nits can be removed with a fine comb. Damage to the eyelashes is treated differently - under the supervision of an ophthalmologist; the eyes cannot be treated with conventional medications. The most important condition for success: simultaneous treatment of all sexual partners in recent months, even without symptoms.
- External antiparasitic agents according to instructions
- Mandatory repeat after 7–10 days
- Removing nits with a fine comb
- Treatment of eyelash lesions only by an ophthalmologist
- Simultaneous treatment of partners
- Refusal of sexual intercourse until completion of the course
Processing of things and prevention
Bed linen, towels and clothes that have been used in the last 2-3 days are washed at a temperature of at least 60 degrees and ironed with a hot iron, especially the seams. Items that cannot be washed are packed in a tight bag for two weeks: without food, the parasite dies. There is no need to treat the entire apartment with insecticides - pubic louse does not live in furniture and carpets. For prevention, limiting the number of partners, using condoms, although they do not completely protect against contact transmission, and refusing to use other people's underwear and towels are important.
- Washing clothes at 60 degrees and above
- Ironing with a hot iron
- Isolate items in a bag for 2 weeks
- There is no need to treat the apartment with insecticides
- Personal towels and linen
- Barrier contraception and partner screening