Felt Louse Infestation (Pediculosis Pubis): Drug Therapy

Therapeutic targets

• Elimination of lice and nits (eggs of the crab louse).
• Partner management, i.e., infected partners, if any, must be located and treated (contacts must be traced for 3 months).

Therapy recommendations

• First-line therapy [guidelines: see below European guideline for the management of pediculosis pubis].
  • 1% permethrin cream (wash off after ten minutes), repeat after seven to ten days or
  • Pyrethrins with piperonyl butoxide (wash off after ten minutes), repeat after seven to ten days.
• Second-line therapy [guidelines: see below European guideline for the management of pediculosis pubis].
  • 0.2% phenothrin lotion (wash off after two hours) or
  • 0.5% malathion lotion (wash off after two hours) or
  • Ivermectin p. o. 200 μg/kg, repeat after seven days (in severe cases 400 μg/kg, repeat after seven days).
• A safe killing of the nits is not given by the active substances. Therefore, the application should be repeated after eight to ten days.
• Prophylaxis: extract from coconut oil.
• See also under “Further therapy“.