Pubic lice

Treating pubic lice

Pubic lice can be treated at home with insecticide cream, lotion or shampoo. Your GP or pharmacist can advise you about which treatment to use and how to use it. It's important to follow this advice.

Some treatments only need to be applied to the affected area, but sometimes the whole body must be treated, taking care to avoid the eyes. The treatment usually needs to be repeated after three to seven days.

If the treatment doesn't work, you may need to use another type. This is because pubic lice can develop resistance to some treatments. Your GP or pharmacist will be able to advise you about suitable alternatives.

To prevent re-infestation, anyone you've had close bodily contact with, including any sexual partners you've had in the past three months, should also be treated, even if they don't have symptoms.

Certain groups, such as young people under 18 years of age and pregnant or breastfeeding women, may require a specific type of treatment. Ask your GP or pharmacist for further advice about this.

Applying a lotion, cream or shampoo

In most cases the instructions for using a lotion, cream or shampoo will be as follows:

apply the product to the affected area, particularly any hairy areas, such as your eyebrows, beard or moustache - depending on the product, you might need to apply it to your whole body, including the scalp, neck, ears and face
be careful not to get the product in your eyes - if you do, rinse your eyes thoroughly with water
reapply the treatment if you wash any part of your body during the treatment time
after the treatment time (stated on the packet) has passed, wash the lotion or cream off
repeat the treatment after three to seven days as instructed

Don't use the medication more than twice. If you think it hasn't worked go to see your GP or pharmacist for advice.

Side effects

Insecticides used to treat pubic lice may cause skin irritation, such as itchiness, redness, stinging or burning. If you have skin irritation, wash the insecticide off the affected area.

Some aqueous and alcohol-based medications may discolour permed, coloured or bleached hair. Check the patient information leaflet.

Follow-up treatment

The first treatment application will probably kill the lice, but the eggs may not have been destroyed. This means more lice could hatch and the cycle will start again.

Reapplying the treatment after three or seven days will ensure that any lice are killed before they're old enough to lay more eggs.

Check for lice a week after your second treatment, or return to your GP, practice nurse, or sexual health clinic so they can check for you.

Finding empty eggshells (dead nits) doesn't necessarily mean you're still infested as they can remain stuck to the hairs even after treatment.

Treating an eyelash infestation

Eyelash infestations are rare. If your eyelashes are infested, seek specialist advice from your doctor. They'll be able to recommend the correct treatment for you.

You can't use the same insecticide lotion or cream that's used on your body because it will irritate your eyes. Make sure you follow the treatment instructions carefully.

Washing clothing, towels and bedding

Wash clothing, towels and bedding in a washing machine. This should be on a hot cycle (50C or higher) to ensure the lice are killed and to prevent reinfection.

Complications of pubic lice

Sometimes, a pubic lice infestation can lead to minor complications, such as skin or eye problems.

Scratching can irritate your skin, or it could lead to an infection such as impetigo (a bacterial skin infection) or furunculosis (boils on the skin).

Eye infections, such as conjunctivitis, and eye inflammation, such as blepharitis, can sometimes develop if your eyelashes have been infested with pubic lice.

Seek medical advice if you have severe skin irritation or sore eyes.