Pubic Lice and Scabies

Pubic Lice and Scabies

Pubic Lice

Public lice, phthrius pubis, are tiny parasites that live on thick body hair predominantly under the arm pits, on the chest or around the pubic area. Pubic lice are spread through close body contact, particularly sexual contact.

According to the 2008 Health Matters Report the incidence of lice is no greater in Gibraltar than other countries, and the percentage is decreasing rapidly often attributed to the large percentage of adults who remove a lot if not all of their own pubic hair.


It can take weeks for symptoms to develop after the initial infection. Symptoms include:

  • Itchiness of the affected area
  • Inflammation and tenderness caused by the itching
  • Tiny spots of blood, around the thighs or abdomen, caused by lice bites
  • The appearance of black powder in the underwear

Unlike head-lice pubic lice are never found on the scalp. They do however lay eggs in sacs that are similar in appearance, pale brown in colour initially but become white once the egg has hatched.


Public lice are spread through direct body contact. The lice crawl from one person to another; they cannot jump or fly. In rare cases sharing a towel or bedding may cause the spread of lice.


It is best to seek advice from a GP regarding the best treatment for a pubic lice infestation. Treatment usually involves the use of an insecticide cream, lotion or shampoo. Some treatments may be recommended for use only on the affected area, however in certain cases it may be necessary to treat the whole body. Treatments are usually repeated after three to seven days.

Pubic lice can develop resistance to some treatments, therefore it may be necessary to try different methods.

To prevent re-infestation it is necessary to have anyone treated who has close body contact or sexual contact, with, even if they are not presenting with any symptoms.


Using condoms will not protect anyone from the spread of pubic lice. It is necessary to avoid sexual contact with anyone known to have an active infestation.

Ensure bedding and underwear is cleaned in hot water. Avoid trying on swimwear without wearing your own underwear underneath.

Limiting your number of sexual partners will also reduce your risk of contracting pubic lice.


Scabies is a skin condition caused by scabies mites, also called sarcoptes scabiei. They feed using their mouths and front legs to burrow into the outer layer of skin, where they also lay eggs. After around three to four days the baby mites (larvae) hatch and move to the surface of the skin, where they mature into adults.


The main symptom of a scabies infection is intense itchiness at the site of the rash, usually worsening at night.

How is it spread?

Scabies is spread through prolonged periods of skin-to-skin contact with an infected person, and also through sexual contact.

It can take from two to six weeks for the symptoms of scabies to appear after the initial infection, which makes it difficult to identify the source of any infection straight away; these eight weeks are known as the mite incubation period.

Who is at risk?

Anyone can get scabies, but certain groups of people are at greater risk through being in close contact with other people. These groups include:

  • children – outbreaks of scabies can occur in schools and nurseries
  • parents – from being in close contact with infected children
  • elderly people – who live in nursing homes
  • sexually active people

Infections are found to be more common in women, and most commonly present during the winter months. 

Mites can survive without a host for an average of 24–36 hours, therefore transmission via shared clothing or bedding can  occur.


The two most common treatments for scabies involve using permethrin cream and/ or malathion lotion. These topical medications contain insecticides that kill the scabies mite.

If you or your partner are diagnosed with genital scabies it is important you avoid having sex and other forms of close bodily contact until the full course of treatment has been completed.