How can you get rid of pubic lice?

Lotions with the active ingredients permethrin or pyrethrin are usually used to get rid of pubic lice. But only pyrethrin is authorized for the treatment of pubic lice – permethrin products are used as ‘off-label’ products.

Infected areas are soaked with the lotion. You then leave it to take effect for about ten minutes before washing it off with water. It is also recommended to carefully comb your pubic hair with a nit comb. That can get rid of the lice’s eggs (nits) that are stuck to the hair, to prevent the lice from coming back.

The products are well tolerated. But the permethrin lotion in particular should only be used after consulting a doctor, especially during pregnancy or if young children are involved.

It is a good idea to see a doctor for a check-up after about one week to see whether the treatment was effective. Because sometimes a single treatment isn't enough, perhaps because the lotion wasn’t left on for long enough or there may have been lice on other parts of the body. Then doctors recommend repeating the procedure.

If the pubic lice also survive the repeat treatment, maybe because they are insensitive (resistant) to the pyrethrin active ingredient, products with the active ingredient ivermectin are available. Ivermectin can also be used in a cream. But it is available in tablet form as well, and is effective in the treatment of pubic lice. The dose depends on your weight and is taken just once – usually several tablets in one go. Like permethrin, ivermectin is prescribed for off-label use. This therapy is not recommended for pregnant women with pubic lice. The side effects include problems affecting the liver and digestion, as well as skin problems like itching and rashes.

To make it easier to comb out the lice eggs (nits), you can soak the hair with a 3-percent vinegar solution – equivalent to household vinegar diluted with water – and then cover it with clingfilm for about one hour. The nits then fall off the hair more easily when combed.

If you like, you can also shave or remove the hair on the affected areas before treatment. That makes the treatment more effective and keeps the lice from coming back. It is important that you carefully dispose of the hair you remove so that the pubic lice can’t be passed on to anybody else. The lice can survive for about 1 to 2 days away from the human body, the nits longer.

Experts recommend applying a lubricating ointment like vaseline to the eyelids and eyelashes if the eye area is infected. It smothers and suffocates the parasites. Your doctor can also carefully remove any nits with tweezers or trim the infected hairs with scissors. But it is advisable not to use sharp implements on your own eyes or other people's eyes to avoid injuries.

If that treatment is not effective on the eyelashes, they can be treated with a permethrin solution that is rinsed off after ten minutes. Therapy with ivermectin tablets is also possible.