Some Basics...

• Pubic lice are tiny wingless insects that live only on human beings. They are also called “crabs.”
• Pubic lice are very easy to spread to others. They are mainly spread through skin-to-skin contact during sex. If you have pubic lice, there is a 95% chance of spreading them during sex. It is possible that they can be spread through things like infected bed linens or toilet seats. But this is very rare.
• Pubic lice are annoying but cause no serious health problems.
• Up to 30% of people with pubic lice also have another sexually transmitted disease (STD).

Symptoms

• Itching of the pubic area is the main symptom.
• Pubic hair has gray bugs (lice) 1/16-inch long. They move quickly and are hard to see.
• Nits (white or tan eggs) stuck to hair shafts near the skin. Unlike dandruff or sand, nits can't be shaken off the hair shafts.

1. What You Should Know:
   • Pubic lice are tiny wingless insects that live only on human beings. They are also called "crabs."
   • Pubic lice are annoying but cause no serious health problems.
   • Pubic lice are spread easily. They are spread by skin-to-skin contact during sex. They cannot jump.
   • You can treat pubic lice at home.
   • Here is some care advice that should help.
2. Treatment - Shampoo Area with Nix: Buy Nix anti-lice creme rinse (permethrin). Follow these instructions:
   • Pour about 2 ounces of the cream onto washed and towel-dried pubic hair. Add a little warm water to work up a lather. Be sure to work the cream into all the hair down to the roots.
   • Leave the Nix on for a full 20 minutes (10 minutes is not long enough to kill all the lice).
   • Rinse the hair and dry it with a towel.
   • Use Nix again in 1 week to kill any nits that were missed.
   • Read all package instructions.
3. Treatment - Using Other Lice Shampoos:
   • There are other over-the-counter lice shampoos made using pyrethrin. Examples include A-200 Clear, R&C, Pronto, and RID.
   • If this type of shampoo is used, it must be put on dry hair.
   • You should repeat the treatment in 7 days to kill and nits that were missed.
   • Read all package instructions.
4. Pregnancy and Breastfeeding: The CDC says that women who are pregnant or breastfeeding can be treated with permethrin products (Nix).
5. Sexual Contacts:
   • Sexual partners that you have had during the last month also need treatment. They still need to be treated even if they don't see any lice.
   • Do not have sex until 2 weeks after treatment. All lice and nits should be gone before you have sex again.
6. What to Expect:
   • With 2 treatments, all lice and nits should be killed.
   • If they come back, this can mean a few things. It most often means you have had another contact with an infected person. It can also mean the treatment was not left on long enough or repeated.
   • Even after treatment, itching may last for 1-2 weeks.
   • There are no lasting problems from having lice. They do not carry other diseases.
7. Pregnancy Test, When in Doubt:
   • If there is a chance that you might be pregnant, use a urine pregnancy test.
   • You can buy a pregnancy test at the drugstore.
   • It works best first thing in the morning.
   • Follow all package instructions.
8. Call Your Doctor If:
   • Pregnancy test is positive or you have trouble with the at-home test
   • Moving lice in pubic hair and it has been more than 6 hours since treatment
   • Pubic lice or nits come back within 1 month
   • You get worse

1. What You Should Know:
   • Only live lice can transmit lice to another person. Nits (lice eggs) do not transmit lice.
   • Most nits (lice eggs) are dead after the first treatment with Nix. The others will be killed with the 2nd treatment in 9 days.
   • Removing the dead nits is not essential. However, it may help with the anti-lice treatment and most people just find the notion of having nits in their hair unpleasant.
2. Instructions:
   • Remove the dead nits and lice by combing with a special nit comb or pull them out one by one.
   • Repeat this every 2-3 days for 3 weeks, until you are sure all of the lice and nits are gone.
   • Wetting the hair with water makes removal easier.
   • Do not use any products that claim they loosen the nits. Here is the reason: they can interfere with the ability of Nix to stay on the hair and keep working.

1. United States - STD Hotline:
   • American Social Health Association STD Hotline provides information on STDs, such as chlamydia, gonorrhea, HPV/genital warts, herpes, and HIV/AIDS. It can provide referrals to local clinics.
   • Toll-free number (English): (800) 227-8922
   • Toll-free number (Spanish): (800) 344-7432
   • Their website is at: http://www.ashastd.org
2. Internet Resources:
   • American Social Health Association: This website has answers to your questions about sexual health and STDs. It can be found at http://www.iwannaknow.org
   • STD Treatment Guidelines 2010, Centers for Disease and Prevention (CDC): This can be found at http://www.cdc.gov/std/treatment/2010/default.htm
   • Public Health Agency of Canada: Sexual health facts and information can be found at http://www.phac-aspc.gc.ca/std-mts/faq_e.html