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Lice
August 2000

Q. Please tell me there are other ways to get pubic lice other than sexual relations. I've been completely faithful to my husband and he doesn't have it, so he didn't give it to me. I am a very clean person and have been extremely freaked out over this. I shaved and the doctor prescribed Lindane lotion. Is this, in your opinion, the right course of action? Is there anything else I can do?

A. Lice are a parasite, and infestations can occur on the head, body, or pubic area. They can be transmitted by close physical contact with an infected person, not necessarily sexual contact. For example, head lice in young children can commonly affect most students in a school classroom setting just from this close contact. In addition it is known that lice can be transmitted from contaminated sheets, towels, and clothing. So it is not always possible to determine exactly the source of the infection.

Lindane is highly effective at killing the lice and their eggs. It is usually applied after bathing and left on for 12-24 hours, followed by bathing again. A fine tooth comb can be used to remove any eggs that remain attached to hair follicles. Laundering recent clothing, sheets, and towels is necessary to avoid re-infection. A second application may be needed in 7-10 days. Some persons will become sensitized and have an allergic skin reaction if repeated applications are necessary. Itching may continue for some time after effective treatment; this can usually be managed with anti-histamine pills. Lindane is usually not used in young children or pregnant women due to potential toxicity, but other effective products are available non-prescription (Rid, Nix, A-200).

HELPFUL WEBSITES:

  • http://www.hsph.harvard.edu/headlice.html
  • http://medlineplus.adam.com/ency/article/000841.htm
MEDICAL REFERENCES (usually available through the library of your local hospital):
  • National Guideline for the Management of Phthiruspubis Infestation. Clinical Effectiveness Group (Association of Genitourinary Medicine and the Medical Society for the Study of Venereal Diseases). Sex Transm Infect. 1999 Aug;75 Suppl 1:S78-9. Billstein SA, Mattaliano VJ Jr.
  • The "Nuisance" Sexually Transmitted Diseases: Molluscum Contagiosum, Scabies, and Crab Lice. Med Clin North Am. 1990 Nov;74(6):1487-505. Review. PMID: 2246949; UI: 91061532
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