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Causes: Pubic lice, or crabs as it is commonly referred to, is most often transmitted from one person to another during sexual activity. Crabs can also be picked up through direct contact with infested clothing, bedding, towels, etc. Lice are not like fleas which can "jump" from one host to a next. Lice are picked up through direct contact, (skin to skin or skin to bedding).
Risk Factors: For the most part, pubic lice are considered a sexually transmitted disease. People who are sexually active with multiple partners are at risk, however, adolescents seem to be more vulnerable then adults. Sharing bedding or clothing with a person who is infected with crabs also puts one at risk.
Children are also susceptible to pubic lice infestation (which may not affect the genital area due to lack of hair) in the eyebrows and eyelashes. According to MedlinePlus, "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." (1)
KidsHealth.org warns, "If your child contracted the lice through sexual contact, you should have your child examined by a doctor to be sure he or she has no other STDs. Pubic lice may also be a symptom of sexual abuse." (2)
Symptoms: The symptoms of crabs are quite obvious to those who are aflicted with the moderate to severe itcing and irritation that accompanies an infestation. Adult crabs and/or their eggs (called nits) may be seen with the aid of a magnifying glass. Pubic lice appear very similar to crabs, hence the name. Lesions due to scratching or the bites may become visible. Infection may occur if left untreated.
Diagnosis: During a doctor's exam, pubic lice are diagnosed through a physical examination with the aid of a microscope or magnifying glass. According the Centers for Disease Control, adult pubic lice may be difficult to spot since they move away from the light. In most patients, there are far more nits (eggs) then adult lice. "If crawling lice are not seen, finding nits confirms that a person is infested and should be treated." (3)
Treatment: Since pubic lice may be an indicator of other sexually transmitted diseases, a physician should guide your examination and treatment options. Crabs can be treated with both prescription strength and over-the-counter medications.
The most common ingredients in pubic lice medications are the same as for head lice and body lice:
Prescription strength medications may include a stronger concentration of these ingredients. Common, over-the-counter, name brand medications for the treatment of pubic lice include Rid and Pronto. Follow the directions carefully when using these medications. See your doctor if there is no improvement after 10 days.
The Centers for Disease Control makes the following recommendations for the treatment of pubic lice:
(1) MedlinePlus Medical Encyclopedia, Pubic Lice, October 2004
(2) KidsHealth.org, Pubic Lice, April 2005
(3) Centers for Disease Control, Division of Parasitic Disease, Pubic Lice Infestation, August 2005
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