National and international guidelines on the management of pubic lice
The BASHH Clinical Effectiveness Group and Sexual Health Dermatology SIG endorse current European guidelines for the management of pediculosis pubis link to page: European guideline for the management of pediculosis pubis 2017 | BASHH
Notes on UK availability of treatment
Use of Permethrin 5% cream (licensed for pubic lice as well as scabies treatment) is safe and effective to use for lice treatment on pubic and body areas other than eye lashes and may be more readily available than Permethrin 1% creme rinse or lotion. One benefit of permethrin is that it has a residual effect in the hair for several hair wash cycles. From BNF and SPC: Advice is to apply to recently cleaned damp hair and all over the whole body (NB Permethrin 5% cream should be left on for 12 hours, then washed off. In contrast the Permethrin 1% crème rinse product lathers and is designed to be washed off after 10 mins).
Malathion 0.5% aqueous solution (applied to the whole body and left on for 12 hours before washing off) is a second line alternative. With both agents, a second application 7 days later is recommended.
Pyrethrins with piperonyl butoxide is not generally available within the UK.
Treatment of infestations on eyelashes
For lice on eyelashes, treat with an inert occlusive ophthalmic ointment (such as simple eye ointment BP) or paraffin eye ointment, twice a day for 8–10 days.
Do not use petroleum jelly (e.g. Vaseline) because it can irritate eyes.
Lice eggs (nits) should be removed with a fine-tooth ‘nit’ comb.
Further information
Scenario: Management | Management | Pubic lice | CKS | NICE