Pubic lice - appearance, causes of infection, symptoms, treatment methods  

Pediculosis pubis (pubic lice) is a disease caused by the parasite Pthirius pubis, which infects human pubic hair. In addition to the genital area, it can affect other areas covered with hair. It is estimated that this disease affects about 2% of the world's population.

The pubic louse is a small insect about the size of a pin. It is from 1 to 3 mm long and has 6 legs. It is characteristic that her hind legs are thicker than her front legs with large claws. The louse cannot jump and feeds exclusively on blood. Humans are the only known hosts of this parasite. Adults are affected more often than children.

Features of pubic lice

These are small insects - up to 3 mm. Females are noticeably larger than males. They have a flattened oval body that is light brown in color. Three pairs of legs are spread wide, so it seems that the width of the insect is greater than its length. The legs are long and pincer-shaped. The structure allows them to move along triangular hair. They cannot attach to the round hairs that grow on the head, so they do not live on the head.

Like other types of lice, pubic lice go through several stages of development:

• nits – white eggs, inside of which larvae develop; this stage takes up to a week;
• nymphs of stages 1, 2 and 3 – in 15–17 days the parasite goes through three moults and becomes sexually mature;
• adults.

Read more in the article “Incubation period of lice and nits”

Pubic louse lives up to 30 days. During its life it lays about 50 eggs.

Without food, the parasite lives for a day. If unfavorable conditions occur, the pubic louse can fall into a state of suspended animation and spend several months in it. Pubic lice can survive up to two days in water. They can withstand loads of up to 1 kg. For example, on the beach, in the sand, they can exist for several days.

Development cycle and reproduction process

The female mate throughout her life and lays eggs. They reproduce very quickly and increase their numbers significantly in a short period of time. Favorable conditions for reproduction are constant human body temperature.

In one day, the female lays about 3 eggs; they are pear-shaped and their size ranges from 0.65 to 0.67 mm. When laying eggs, the female secretes a special adhesive substance, thanks to which the nit is securely attached to the hair.

One nit is deposited on one hair. Nits, as well as insects in the imago stage, are highly viable. They can withstand temperatures up to 50° for half an hour. In addition, they can easily tolerate such a caustic and aggressive substance as kerosene within 10 minutes.

It takes 4 to 8 days for nits to develop. Next comes the larval stage, which lasts from 10 to 12 days. During this time, the individual goes through 3 moults and transforms into the imago stage; this is a young individual capable of mating and reproducing. The female lives only 2 weeks. Pubic lice breed throughout the year, but peak numbers occur from September through November and February.

Where can you find pubic lice?

As mentioned above, pubic lice live on the hairy parts of the human body, but do not affect all the hair. They are attracted to areas with apocrine glands that secrete a special secretion:

• pubis;
• crotch;
• anus;
• scrotum;
• armpits.

The affected areas are always covered with hair. These parasites do not live on smooth skin. The disease occurs in both men and women. Children can also become infected with it if they have hair on their genitals.

Signs of appearance

Pubic lice do not live on smooth skin. They can only live on hair with a triangular cross-section, meaning they cannot be found on hair growing on the head. Lice most actively inhabit the following places:

• crotch;
• pubis;
• scrotum;
• anal area;
• armpits.

In men with lice pubis, parasites can settle on the hair in the lower abdomen and on the beard. In case of severe infestation, lice can be found on eyelashes and eyebrows.

The main symptoms of pubic lice are:

• constant itching, usually worse at night;
• bite marks, grayish-blue spots on the skin (appear due to a substance that prevents blood clotting, which the parasite injects at the time of the bite);
• skin damage resulting from constant scratching of itchy skin, in severe cases dermatitis, eczema, blisters;
• matted, tangled pubic hair (due to a sticky substance secreted by females to lay eggs);
• poor sleep, anxiety, irritability.

Bad dream

Not only adult men or women, but also children can become infected with pubic lice. It can take 2 to 4 weeks from the moment of pubic lice infestation until the first signs appear.

How can you become infected with phthiriasis?

There are several ways the disease can spread. The most susceptible to this are women and men who lead an antisocial lifestyle and promiscuous sex life, as well as those who do not maintain personal hygiene.

But you can also catch pubic lice through:

• clothes of a sick person;
• towels and bed linen;
• public toilets;
• beaches, solariums;
• baths, saunas, swimming pools, etc.

Even with careful hygiene, no one is protected from infection, so it is important to be careful when visiting public places and communicating with potential carriers of parasites.

Methods of infection

There are predisposing factors that significantly increase the risk of infection, these include large crowds of people, unsatisfactory sanitary and living conditions. It is also worth noting that in cold weather the risk of infection increases.

Routes of infection may be as follows:

• Domestic. Infection can occur due to the use of infected clothing, bedding, and toilet seats.
• Intimacy.
• When using general beard and mustache brushes, applies to men.

Symptoms of phthiriasis

Pubic lice can be seen without the use of special equipment. They are small, but move quite quickly. Nits are very small and are attached at the very base of the hairs, so they can be very difficult to notice.

In addition to a visual examination, you can find out about the presence of phthiriasis by the following symptoms:

• constant itching - it occurs due to the fact that when bitten, the parasite injects a substance under the skin that is an active irritant;
• small blue dots at the bite sites are traces of an injected substance that prevents blood clotting;
• Due to unbearable itching, a person scratches the skin, skin damage appears, including dermatitis and eczema.

When affected by phthiriasis, a person becomes restless and irritable.

Sometimes symptoms appear even with a small number of parasites on the body. They may not be seen due to the fact that they are hidden in matted and thick curls of hair. In this case, you should consult a doctor to confirm the diagnosis. The specialist uses the following methods for detecting parasites:

• examination with a Wood's lamp - it allows you to see live nits, which in its fluorescent light look white, and dead ones remain gray;
• examination of the affected areas at multiple magnification using a videodermatoscope;
• Examination of the eyes with a slit lamp to detect nits on the eyelashes.

Diagnosis of the disease

For an accurate diagnosis, a parasitological examination is required, as well as a general assessment of the clinical picture. During the examination, a slit lamp is used, which makes it possible to conduct diagnostics on the eyelashes and eyebrows.

In men, an examination is carried out in the genital area, abdomen, back, and chest. In women and children, these areas are also examined, but in this case, vellus hair.

Detection methods include:

• The use of a Wood's lamp, thanks to which nits can be identified; if they are present, a pearl-white glow appears.
• A white sheet of paper is used, onto which insects are combed out using a fine comb.
• Visual inspection makes it possible to detect parasite eggs; both living and dead, empty egg shells can be observed.
• Also, visual inspection makes it possible to detect adult individuals.

For visual inspection, a magnifying glass or microscope is used.

Diagnosis can also be carried out using modern technology - a videoscopic digital system. It consists of a small specialized video camera that is connected to a computer.

During inspection, the camera captures the insects, enlarges them several times, and the image is displayed on the screen. The computer saves the image and analyzes it. This makes it possible to quickly diagnose and prescribe effective treatment to the patient.

Why is phthiriasis dangerous?

Skin damaged by scratching is favorable conditions for infections to enter the body. The scratched areas become infected, ulcers and boils appear on them. If left untreated, the infection goes deeper into the lymph system. This can lead to systemic diseases and blood poisoning. Pubic lice, with their saliva, transmit infectious diseases, such as typhoid, from person to person.

Many patients experience allergic reactions. Also, phthiriasis is almost always accompanied by sexually transmitted diseases. It could be chlamydia, gonorrhea, syphilis. Pubic lice, passing from person to person, carry the causative agents of these diseases in their saliva. This is precisely what causes the most danger of infection with lice pubis.

When a person is very seriously affected and there are a large number of lice, they do not have enough space to live in the groin and armpits. In this case, they can live on eyebrows and eyelashes. When these areas are affected, conjunctivitis, blepharitis and other eye diseases develop.

Consequences after the disease

In addition to the fact that these parasites bring great discomfort and inconvenience to a person, there is a risk of developing pustular lesions. Itching leads to scratching of the skin, and infection and pyogenic microbes get into these wounds.

If the affected area is the eyelashes, an inflamed red streak appears on the upper eyelid, and conjunctivitis may also develop. Statistics show that 65% of those infected have scabies, and 35% have concomitant sexually transmitted diseases.

Lice themselves do not cause infectious diseases and do not transmit them, but their parasitic lifestyle and wounds on the skin from scratching are ideal conditions for the spread of infections. If treatment does not occur, eczema, boils, and abscesses often develop. Blepharitis forms on the eyelids and the mucous membranes become inflamed.

Only the correct treatment, which a specialist has selected for the patient, taking into account individual indications, can get rid of parasites and prevent the development of complications.

Ways to combat pubic lice

Getting rid of pubic lice is much easier than getting rid of head or body lice. The most effective way is mechanical. That is, you just need to remove all hair from the affected area so that parasites do not have the opportunity to live on the body. They cannot move on smooth skin. The “fashion” for hair removal in intimate areas over the past few years has significantly reduced the incidence of this disease.

If you are infested with pubic lice, you need to shave or otherwise remove the hair on the infected area. It is better to remove hair from the entire body so as not to leave any opportunity for parasites to survive unfavorable conditions nearby. After hair removal, it is advisable to apply pediculicide to the affected area to destroy nits, which, due to their small size, can be hidden in the skin flakes.

If for some reason it is impossible to use the mechanical method, then you can use folk remedies or special preparations that kill lice and nits.

How to remove parasites: effective means

To treat phthiriasis, external, local drugs are used - they are prescribed by a doctor. There are several effective remedies.

Dimethicone

May be part of a complex of mineral oils, does not contain insecticides. Available as shampoo, spray or lotion. Can be used for children aged three years and older.

Permethrin

An external cream based on this substance is used to treat or prevent head lice. Also comes in shampoo form. The preventive effect can last for a period of two to six weeks.

Boric acid

Medicinal ointments have been developed based on this active ingredient. According to the instructions, the ointment is applied to the scalp and then washed off. The hair is combed out with a comb. The treatment can be repeated daily. Additionally, boric ointment has an antiseptic effect.

In any case, you should consult your doctor before using any drug. It is also important to study the instructions so as not to cause harm by self-medication.

Almost all medications for lice pubis contain permethrin, an insecticidal substance. It destroys pubic lice and nits, paralyzing them and stopping their breathing. Permethrin has a characteristic orange-brown color and a specific odor. Preparations containing this insecticide should be used strictly as prescribed by a doctor and with caution:

• the substance may cause allergies, redness of the skin, increased itching, burning, tingling or tingling;
• when treating phthiriasis and applying products containing permethrin to the skin in the genital area, it is necessary to avoid its contact with the mucous membranes;
• insecticides are not used to kill pubic lice on eyebrows and eyelashes;
• when using insecticidal creams, ointments, shampoos, it is advisable to protect the skin of your hands with disposable gloves or wash your hands thoroughly with soap immediately after using the drug;
• External products based on permethrin are not used to treat head lice in children.

Age restrictions are indicated in the instructions for a specific drug. If a child is infected with phthiriasis, any insecticidal preparations can be used only as prescribed by a doctor.

To reduce the risk of a local reaction, before using a cream, lotion, shampoo or other product containing permethrin, you can apply a small amount to the skin to see if it causes allergies, itching, burning or other unpleasant symptoms.

Folk remedies

Traditional medicine involves the use of a mixture of vegetable oil with kerosene, essential oils, petroleum jelly, and other products that need to be applied to the affected area. This treatment is ineffective: if it leaves at least a few live insects or eggs, pubic lice will continue to multiply. The use of kerosene and other aggressive agents is dangerous: there is a risk of injuring the skin and causing allergies. It is better to use medications prescribed by your doctor. A single use of insecticides is enough to get rid of phthiriasis.

Important! If you are infected with lice pubis, you should not try to treat the disease yourself: some remedies can stimulate the proliferation of pubic lice. Therefore, for diagnosis and treatment you need to contact a dermatovenerologist.

After treating the skin with insecticidal agents, it is necessary to wash clothes, bedding and any other things that may have pubic lice on them. Washing is carried out at a temperature not lower than +50°C.

Folk remedies

These are the same products that are used to kill hair or body lice and nits. The affected areas are lubricated with the following means:

• vinegar solution;
• pulp of crushed cranberries;
• Castor oil;
• geranium oil

All these options are quite gentle. They do not cause harm to health, but require long-term use for the effect to occur. If they are severely infested with pubic lice, they are powerless. In addition, you will have to leave the product on the affected areas for some time to work. This is not always convenient or appropriate.

More aggressive options can be used:

• 3% hydrogen peroxide;
• boric or sulfur ointments;
• kerosene.

They must be used with great caution, as these products may be toxic or cause burns to the mucous membranes. In addition, they may not be effective against nits.

Consequences and complications

If lice pubis is not treated, the parasites will continue to multiply. A sick person will infect people in close contact with him. The risks to his health are mainly associated with inflammation, the appearance of ulcers on the skin, and the addition of a secondary infection.

After treatment for several weeks, dead nits may be found on the affected area. This does not require re-treating the skin or hair with the insecticide.

If a pregnant woman becomes infected with phthiriasis, drugs with a minimum concentration of the toxic active substance are chosen during treatment. Pediculosis pubis is not dangerous for newborns; they cannot catch it from their mother. The risks of phthiriasis during pregnancy are associated mainly with the addition of a secondary infection if the disease is accompanied by severe itching and the appearance of ulcers, scratching, and inflammation on the skin.

Professional products

Phthiriasis should be treated with medication using effective agents that work against lice and nits. These are pediculicides that kill parasites. You can use drugs based on different active ingredients: Medilis-Permifen, Medilis-Bio, Medilis-Malathion or Medilis-Super. They are available in the form of a spray or emulsions. Each drug is accompanied by instructions for use, which must be strictly followed. Most drugs can be used by people who do not have individual intolerance. Some can be used to treat children from 5 years of age. The result will come within a few minutes or hours.

What does a pubic louse look like?

Let's take a closer look at what a pubic louse looks like, and what its bites look like. In the 20s of the last century, Russian scientists E. Pavlovsky and A. Stein described in detail the life cycle of the plant.

In English, the pubic louse is called a crab, due to its external resemblance to a crab. The adult is about 1.3-2 mm long (slightly smaller than body and head lice). It can also be distinguished from other species by its almost round body. Another distinctive feature of Phthirus pubis is that the back two pairs of legs are much thicker than the front legs and have a large claw to hold it firmly on a thread.

The ploshchitsa can climb up its hair, move across its body over short distances, feeds only on blood, drinks blood 4-5 times a day. It moves best at a temperature of about 25-27*C; at a temperature of -5*C it becomes motionless. It can live outside the human body for about two days.

If you leave clothes for three weeks in a dry, closed place, the lice on them will reliably die, and they also die under water within 48 hours. A temperature of 98*C kills them in 7 minutes, a temperature of 54*C in 35 minutes. And from 2% carbolic acid or 2% Lysol they die in about 10 minutes.

The louse has a sense of smell and can smell the human body at a distance of a couple of centimeters. Pavlovsky and Stein, who studied the behavior of lice, believed that there are people who are immune to lice and resistant to infection with lice pubis. Obviously, well-fed individuals do not bite everyone and are sensitive to repellent odors.

Phthirus pubis reproduces relatively slowly

Individuals are dioecious, females lay few eggs, 3 eggs per day at a time. Nit eggs are shaped like a pear with a domed cap. Nits are glued to the hair with a special wax, a product of the adhesive glands secreted by the adult.

What pubic lice bites look like on the human body macula cerulea

A type of pediculosis in which the pubic louse nests on the eyelashes is more common in children and even infants. Very often this type of pediculosis is mistaken for demodicosis.

What must be done when treating phthiriasis

Pubic lice can hide not only on a person’s body, but also in his personal belongings. Therefore, during treatment, it is important to treat underwear, clothing, bedding, and towels. It is better to soak all items that can be washed in a pediculicide solution and wash at high temperature, and after drying, carefully iron or treat with a steam generator. Closets where clothes and linen are stored should be washed with a pediculicide solution. It is advisable to treat mattresses and upholstered furniture with a steam cleaner. Since lice can wait out unfavorable times in a state of suspended animation, it is necessary to do a general cleaning and wash all surfaces with an insecticide solution. This will remove insects from the home that could survive the treatment and then return to the human body.

How dangerous is Phthirus pubis?

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Fortunately, these insects are not carriers of dangerous diseases, unlike the body and head varieties. But any bites cannot pass without a trace. The consequences appear as:

• Itching and bite marks;
• A bluish spot at the site of the bite.

Interesting! The appearance of a blue spot is associated with the breakdown of hemoglobin under the influence of saliva. The blue color is characteristic of decay products concentrated at the site of the bite.

• Since the bites are scratched, many papules and pustular inflammations form in their place. And if the case is advanced, then pyoderma occurs.
• If eyelashes and eyebrows are affected, blepharitis and conjunctivitis may develop.

Pubic lice, unlike their relatives head and body lice, have a more crab-like structure.

Prevention

Pubic lice can affect anyone, regardless of their lifestyle. To reduce the likelihood of illness, you should take the following measures:

• carefully observe personal hygiene;
• do not engage in sexual contact with strangers;
• do not use other people's bed linen;
• do not wear other people's clothes and underwear;
• do not use other people's towels.

In public places, you should protect yourself as much as possible from lice. For example, you should not sit on the seats in the sauna or in the changing room of the swimming pool without a personal sheet or bedding.

After visiting a place where infection is possible, you must thoroughly wash, wash and iron your clothes with a hot iron. For prevention purposes, it is worth removing hair in intimate areas.

If you suspect a pubic lice infestation, you should consult a doctor and begin treatment, preventing the insect population from increasing many times over. If you start fighting right away, you can get rid of them quickly and without health consequences.

Frequently asked questions (FAQ)

The most popular questions and answers to them:

Expert opinion

Alexandra Valerievna

Doctor-Trichologist

How are lice pubis and scabies related?

Both diseases are caused by parasitic insects and are transmitted both sexually and domestically. The scabies mite spreads quickly, as does the scabies mite. After infection, severe itching occurs in the affected areas.

How are head lice different from pubic lice?

They have completely different paw structures, so the pubic area never extends onto the head. It can only move and be held on hair that has a triangular cross-section. The scalp area contains round hair and is more suitable for head lice.

Spray for pubic lice

Sprays are highly effective in the fight against pubic lice. They are easy to use and act quickly.

Paranit (approx. 600 rubles)

The spray includes coconut, anise, and ylang-ylang oils. It needs to be distributed over areas affected by parasites, and then removed with a comb or a hard sponge. Before use, you need to make sure that there is no individual intolerance to the components.

Pediculen Ultra (from RUR 67)

The composition contains anise oil and alcohol . In just one application, the spray destroys all of them, and then you just need to comb them out. The product must be sprayed carefully, avoiding contact with the eyes.

Pax (from 350 rubles)

A combination product that contains neurotox. The component helps remove parasites, and in simple cases it is enough to use it only once. After using the aerosol, the treated areas are thoroughly washed with water and soap.

Treatment of lice at home

In the modern world, it is very difficult to completely protect yourself from head lice, since a person visits crowded places almost every day. For this reason, it is best to know how to treat pubic lice symptoms at home.

A significant disadvantage of such procedures is the time spent on therapy. It can last up to 10 days and sometimes be carried out more than once. Ointments and other medicines purchased at a pharmacy act much faster, and the dosage of the constituent substances is calculated by specialists.

Treatment with kerosene

Treatment of lice pubis at home has long been carried out with kerosene diluted with a small amount of water. The principle is quite simple: a small amount of liquid is applied to the entire hairline for a few minutes and then the affected area is thoroughly washed with water.

It is worth noting that this method has already been studied and the consequences of it can be simply catastrophic. Kerosene can burn the mucous membranes of the genital organs and skin, so you can use it only at your own peril and risk.

Mint decoction

You can remove pubic louse with a decoction of mint and pomegranate juice.

It is important that the juice is natural, because it retains the nutrients that promote healing. Peppermint is used in pre-dried form, two tablespoons of the dry component are mixed with 200 grams of pomegranate juice

The resulting consistency should be boiled for no more than 2 minutes. Next, the product is cooled and rubbed into the affected areas twice a day.

It is worth noting that you need to be patient, as the course of therapy will last from 5 to 10 days.

Boric and sulfur-mercury ointments

Sulfur-mercury and boron ointments are effective in treating pubic lice, but pregnant women should always consult a doctor before using them. Sulfur-mercury ointment is toxic, so it must be used very carefully, being careful not to get the mixture on the mucous membranes of the genital organs.

5% boric ointment is rubbed into the affected areas and after a few minutes the hair should be rinsed with water. Therapy continues for three days and in some cases it requires repetition.

Cranberry juice

Cranberry juice may be effective in treating lice pubis. The mixture helps remove parasites from the skin and hair; therapy lasts 7 days. The juice is rubbed into the affected areas and washed off with running water after a few minutes.

Vinegar diluted with water is considered one of the most effective methods of getting rid of lice at home. The mixture is rubbed into the affected areas, and the lice are combed out with a comb.

The vinegar solution helps remove parasites from the hair.

It is worth noting that this method, although effective, is quite dangerous, so it should be used with caution

Ledum and Cheremitsa

Herbs are taken in dried form, two tablespoons each. The dry mixture is mixed with 30 grams of pork fat and placed in a water bath. After the product has cooled, it is rubbed into the affected areas. The course of therapy can last from 7 to 10 days.

Timely treatment of pubic lice at home quickly leads to getting rid of lice.

It is worth noting that the symptoms, even after complete recovery, do not disappear immediately; itching and burning may continue to bother you for several days.

When lice appear, do not be shy; anyone can become infected with them. Timely therapy will be most effective, so at the first symptoms of the disease you should consult a doctor for help.

Pubic lice: causes, diagnosis and treatment at home.

If pubic lice appear, treatment at home should be based on products that kill both adults and nits.

Pediculosis pubis is a disease caused by pubic lice. This type of parasite infects the body and is able to survive only on the human body. If lice are found, you should immediately take measures to eliminate them. In most cases, patients are embarrassed to seek qualified medical help and try to cope with treatment themselves.

Let's take a closer look at how to get rid of the disease forever and what methods to treat it most effectively.

Treatment

You need to start specialized treatment for pubic pediculosis immediately after a dermatovenerologist has made the correct diagnosis. Complex therapy for phthiriasis includes the following:

• Emulsion Medifox 5%. It must be dissolved in warm water (the amount is indicated in the instructions) and applied to the hair. After 20 minutes of exposure to the drug, you need to take a shower.
• Nittifor solution, undiluted, is rubbed into the skin of the affected area. The exposure time of the product is 40 minutes, the procedure must be repeated a week after the first application.
• They should treat the areas of the body affected by pubic lice with Vitar soap, and after 2-3 minutes, rinse with warm running water. Experts recommend repeating the procedure after a week.
• Pedilin is an anti-pediculosis agent produced in the form of shampoo. The drug should be applied to the affected area using a cotton pad, intensively rubbing into the roots and rinsed off after half an hour. Re-application of the drug must be repeated after 14 days.
• Antihistamines Loratadine and Suprastin are used as additional medications (in the presence of allergy symptoms).
• If pustular complications are detected, antibiotics of the penicillin and cephalosporin series are prescribed, as well as treatment of the affected areas with solutions of local antiseptics.

Products for the treatment of phthiriasis must contain aggressive insecticidal components, such as cypermethrin or deltamethrin. During the first treatment, adult insects die; during the second treatment (after a week), the larvae that hatch from the surviving eggs are destroyed.

In case of severe complications of phthiriasis, such as Quincke's edema, anaphylactic shock or sepsis, the patient should be treated in a specialized hospital.

When diagnosing phthiriasis, the patient needs to shave the hair in the genital area and around the anus, in the armpits and, in rare cases, on the chest or head. It is not recommended to remove hair by other methods (waxing, sugaring), since these manipulations lead to additional damage to the skin.

Treatment for phthiriasis should also be carried out on the sexual partner of a sick person. Much attention is paid to preventing the spread of the disease in the home, in order to prevent infection of people living in the same area as the patient.

In the video, doctors talk in detail about the methods of infection with phthiriasis, symptoms and treatment of the disease.

Inexpensive and effective drugs

You can pay attention to the following products that combine affordable price and good quality.

Veda (approx. 200 rubles) - shampoo with antiparasitic properties that helps eliminate lice and larvae. It should be applied to the affected area, and after half an hour, washed off with soap. After 7-10 days, the procedure is repeated.

Lavinal (from 300 RUR) – Helps cope not only with adult lice, but also with nits. The active component of the composition, acting on the nervous system of parasites, provokes their paralysis and death.

Mercury-sulfur ointment (from 23 rubles) – The product has a detrimental effect on pubic lice, but it must be used carefully. It is rubbed into the affected area for a course of two weeks.

How is pathology diagnosed?

According to modern ideas, pediculosis pubis is considered a disease that is rarely diagnosed. This is due to the fact that the main diagnostic method for detecting pediculosis, including pubic lice, is a superficial examination of the human body. Moreover, the criterion for diagnostic accuracy is the indispensable detection of live lice. Since nits do not necessarily lead to lice, they are not an indication for temporarily isolating a person from others.

Diagnosis is often made by combing the hair with a fine-toothed comb, which reveals live lice or nits, which the doctor can see with the naked eye or with a magnifying glass. Videodermatoscopy also allows you to identify pubic lice in the presence of a large amount of dandruff.

PEDICULOSIS (lice)

Pediculosis (lice) is caused by parasites that live on human skin and feed on his blood.
Infection occurs through contact with a lice-infected patient. Lice develops under unfavorable sanitary and hygienic conditions. However, pediculosis can also occur in completely clean and prosperous citizens upon contact with a sick person. It is believed that bursts of solar activity, enhancing the growth and reproduction of parasites, as well as a decrease in the general immunological reactivity of the population, may play a role in the spread of lice.

The group of lice includes three species, each of which causes one of the manifestations of lice.

Head lice (Pediculus humanus capitis)

A head louse is evidence of hygienic problems in the community where it has the opportunity to spread.
It lives on the scalp, feeds on blood and lays eggs, attaching them to the hair - these are nits that are easy to see with the naked eye. Over the course of 20–30 days, the louse lays up to 10 eggs (nits) per day. After 8 - 10 days, larvae form from the nit, which then turn into an adult louse, which after 10 - 15 days begins to lay eggs on its own. The lifespan of a louse is up to 38 days. Head lice occur at any age, but they are most often observed in girls and women. Infection occurs through hats, hairbrushes, combs, and also through direct contact with the patient. Outside the host, a head louse can live for about 55 hours. Outbreaks of pediculosis are known in schools, kindergartens, sanatoriums, and summer camps. The disease is characterized by severe itching at the site of the insect bite and irritation that occurs due to the action of the secretion of the salivary glands. Most often, patients are bothered by itching of the scalp, especially in the back of the head, temples and behind the ears. As a result of itching, scratches and crusts appear, and a secondary infection may occur. As pyoderma develops, nearby lymph nodes become enlarged. Purulent crusts appear at the site of scratching. In severe cases, a tangle is formed - a mass of tangled hair, lice, nits, and crusts glued together with exudate.

Body lice (Pediculus humanus corporis or Pediculus humanus vestimenti)

Body lice are carriers of typhus and relapsing fever.
They parasitize in places where the folds and seams of linen come into contact with the body. Untidy adults get sick more often, children less often. When in contact with the human body, the body louse moves to the skin only to suck blood. The body louse lives and lays nits in the folds of clothes and linen. On human skin, body lice are usually found in the neck area, between the shoulder blades and in the lumbar region; subsequently, secondary light brown pigmentation persists in these places for a long time. At the sites of bites, vascular spots and itchy papulourtic elements are visible. As the itching increases, scratching appears and a secondary infection may develop. With a long course of the disease, areas of thickened skin with scratching, peeling, and a light brown or dirty gray color develop in these areas. After treatment, hyperpigmented spots remain.

Pubic lice (Pediculus pubis)

Pubic lice, usually found in adults, are spread through sexual contact.
Pubic lice is a sexually transmitted infection. Infection through a shared bed, washcloth, or towel is possible, but this route of transmission is rare. The pubic louse - the flat louse - lays eggs at the base of the hair, and itself is attached with its proboscis to the mouths of the hair follicles, usually on the skin of the pubis and scrotum, but can be found on the abdomen and other areas of the skin covered with hair, especially bristly (pediculosis in the eyebrow area is often found, eyelashes, mustache, beard, armpits). The pubic louse looks like a gray-brown speck 1-2 mm in size, which is attached to the base of the hair, while its mouthparts are buried in the skin. She sits in one place for several days. The number of lice is small. Pubic lice bites cause severe itching of the skin and, as a result, scratching. At the sites of flatworm bites, round bluish-gray nodules with a diameter of 3 mm to 1 cm appear.

Treatment of pediculosis

Treatment of pediculosis a few years ago was fraught with some difficulties.
In particular, to treat head lice, a 10% water soap-kerosene emulsion was used, which was applied to the scalp for 30 minutes, and then the hair was washed with soap and the hair was combed with a fine comb to remove dead parasites. Toxic compounds were also used - 0.15% aqueous emulsion of karbofos, 10% sulfur ointment, 20% ointment or water-soap emulsion of benzyl benzoate. The treatment had to be carried out repeatedly. For the treatment of head and pubic lice, the universal preparations Medifox and Medifox-super are used (the active ingredient is permethrin, 5% and 20%, respectively). The drugs are 100% ovicidal. To treat the scalp, 2 ml of Medifox is mixed with 30 ml of water, then the aqueous emulsion is applied with a swab to moistened hair. After 20 minutes, wash off with warm running water and shampoo. The most economical is Medifox-super; 0.5-1 ml of the product is enough to treat one person.

Medifox and Medifox-super are also used for treating underwear, bed linen, outerwear and for disinsection of premises from lice and scabies mites. Underwear and bed linen are soaked in a water emulsion or irrigated until lightly moistened. After disinfestation, the laundry is thoroughly rinsed and soaked for a day in a solution of soda ash, after which it is washed in the usual way. Insect habitats - collars, belts, seams, folds - are treated with special care. Treated items can be used after drying and airing. Medifox-super is approved for treating clothing to prevent lice infection. Underwear and outerwear are irrigated with Medifox-super water emulsion. After airing, the treated items can be worn for a week or until a scheduled change of linen. Treated clothing protects a person from lice, even if he gets into the center of lice. As a result, he ceases to be a carrier of lice.

Nittyfor. Destroys nits, larvae and mature individuals of head and pubic lice. Solution for external use: 60 ml (300 mg permethrin) in a bottle.

Mode of application. Moisten the hair generously with the solution using a cotton swab, rubbing the preparation into the hair roots. Typically, 10 to 60 ml of the drug is consumed per person, depending on the thickness and length of the hair. After treatment, the head is covered with a scarf, and after 40 minutes the nittifor is washed off with warm running water and soap or shampoo. After washing, the hair is combed with a fine comb to remove dead insects.

The high effectiveness of the drugs paraplus, spray-pax, and A-PAR has been proven. They are produced in a convenient form. It is very important that these drugs are safe, do not cause side effects or complications and require a single use. Thanks to the use of A-PAR, paraplus, and spray-pax preparations, the treatment time for head lice has been significantly reduced. Treatment begins with washing the body with soap, changing and disinfecting underwear and bed linen. To treat clothing, bed linen, mattresses and blankets, A-PAR is used, which contains active substances: esdepalitrin, piperonyl butoxide. A-PAR is used as part of a set of measures to treat parasitic diseases and helps avoid re-infections. The preparation does not leave stains on fabrics; when using it, subsequent washing of the treated items is not required. Esdepalletrin, which is part of this drug, acts at the level of the nervous system of insects: it disrupts the cation conductivity of nerve cells. Upon contact with the active substance, the insect begins to experience agitation, convulsions and paralysis. Death occurs due to paralysis. Using one cylinder allows you to process a set of things for 2-3 people at once.

Simultaneously with the treatment of clothing, linen, and bedding, pediculosis is treated.

Paraplus. It is used to treat head lice and destroys nits and lice.

Aerosol for external use: 90 g in a bottle (spray can). It contains: permethrin, malathion, piperonyl butoxide.

Permethrin, which is part of the drug, is a neurotoxic poison for insects. Other components of the drug enhance the effect of permethrin and prevent the development of resistance to the drug.

Mode of application. The drug is sprayed from a can onto the scalp and the entire length of the hair. Exposure of the drug is 10 minutes. Then you need to wash your hair with shampoo. Dead parasites and nits are combed out with a fine comb.

Spray pack. Used to treat lice pubis.

Aerosol for external use. Contains pyrethrum extract 25%, piperonyl butoxide. Natural pyrethrins (pyrethrum flower extract) and piperonyl butoxide have a pediculocidal effect.

Mode of application. The drug is sprayed onto the pubic hair and left for 30 minutes, then washed thoroughly with soap and rinsed with water. One-time use is sufficient.

To avoid re-infection, it is necessary to treat clothing, hats, and bedding with A-PAR. It is necessary to avoid getting the drug on the face. If you accidentally get the medicine into your eyes, rinse them thoroughly with warm water.

If lice is detected in at least one family member, it is necessary to carry out preventive treatment of the belongings of all family members who are in close contact with the patient.

Prevention of head lice requires compliance with basic hygiene measures. An important preventive measure is a careful examination of all those entering hospital treatment, as well as conscripts returning from leave, children in kindergartens and schools.

N. G. Korotky, Doctor of Medical Sciences, Professor N. M. Sharova Russian State Medical University, Moscow