Wed | Feb 26, 2020

Dear Doc | Pubic lice itching like dandruff

Published:Sunday | February 9, 2020 | 12:11 AM

Q I would like to know if men can get dandruff on their testicles? For me, it started with a lot of itching down there. I thought my girlfriend had given me a yeast infection. However, she said she didn’t have one. She then told me that she saw some white, shiny-looking things on my hair down there, near to the skin, and that it must be dandruff, because it flaked and moved when she scratched it with her fingernails. Will regular dandruff shampoo work to fix it, or do I have to get something special for that kind of dandruff?


A Unfortunately, the answer is no. I do not believe you have dandruff. Based on the symptoms you have described, it appears you might have pubic lice, or what we commonly know as crab louse or ‘crabs’.

Pubic lice are very small insects that infest your genital area. The pubic louse is tiny and round. It is difficult to see unless it is filled with blood from a recent feeding. It has crab-like claws that allow it to grasp tightly on to hair.

Pubic lice are spread through sexual contact, affecting both men and women. You can also acquire pubic lice from contaminated sheets, blankets, towels, or clothes.

Although these lice primarily affect the pubic area, they can also be found on other areas of the body, such as eyebrows, armpits, beard, and moustache. Pubic lice are not found on the head.

People with pubic lice have itching in the pubic or genital area, and the itching becomes more intense at night. If other parts of the body, such as the armpits, are affected, there can also be itching present in those areas. There might be areas that look like bruised spots on the lower belly, upper thighs, or buttocks, from repeat lice feedings in the same area.

If after reading the above you think that you may have pubic lice, it can be easily diagnosed. Your doctor can diagnose pubic lice by simply looking at the genital area for lice or their eggs. The eggs are tiny and white, and are usually found around the roots of pubic hair. I believe this is what your girlfriend saw.

If you are diagnosed with pubic lice, which is a sexually transmitted infection, you should get tested for other sexually transmitted infections, such as gonorrhoea, chlamydia, syphilis, and HIV. You should also tell anyone that you have had sex with during the previous month to get treated. You should not have sex again until you are both treated.

Treatment for pubic lice consists of decontaminating yourself, your clothes, and your bedding.

Over-the-counter lotions and shampoos can be used to remove pubic lice from your body. The most commonly used treatments include permethrin (Nix, Rid) and pyrethrin (A-200, Pronto, Tisit)

Before using the treatment, your skin should be cool and dry. You should apply the lotion or cream to the skin and hair in the pubic area, as well as the skin around the anus. Other hairy areas, such as the underarms, chest, back, and thighs, should also be treated. After 10 minutes, rinse the treatment off with water.

After treatment, you can remove with your fingernails, a fine-toothed comb, or tweezers, any lice that you see.

Some persons need a second treatment to get rid of pubic lice. Prescription medication might also be necessary if the topical solutions do not work.

Your doctor may ask you to return for an exam after your treatment to see if there are any remaining lice before doing a second treatment. Your doctor may also ask you to do a second treatment nine to 10 days after your first treatment.

Occasionally, lice infestation does not resolve despite proper use of the treatment, and a different treatment may be necessary.

You may have heard of some home remedies, such as shaving the area and taking hot baths. However, this alone will not be effective for treating pubic lice, but can help make treatment more effective.

To decontaminate your clothing and bedding, you should wash all your clothes, towels, and bedding used within the three days before you started your treatment. Wash them in hot water and dry them on the hottest dryer setting. Dry cleaning is also an option for cleaning clothing.

If there are items that cannot be washed or dry cleaned, you can place the item in a sealed plastic bag for two weeks.