Pubic lice (Pthirus pubis) are tiny parasitic insects that typically infest the pubic area. Often called “crabs” due to their crab-like front legs, their primary habitat is coarse body hair, such as in the genital region. However, they can also infest other hairy parts of the body, including the eyelashes. This article focuses on pubic lice infestations specifically affecting the eyelashes.
How Pubic Lice Infest Eyelashes
Pubic lice are distinct from head lice (Pediculus humanus capitis) and body lice (Pediculus humanus corporis). They are small, measuring about 1/16 inch (1.6 millimeters), and have a shorter, rounder body shape compared to head lice. These parasites feed on human blood and cannot survive more than one or two days without a host.
Transmission primarily occurs through direct skin-to-skin contact, most often during sexual activity. While sexual contact is the most common route, transmission can also occur through close, non-sexual contact, such as sharing bedding, towels, or clothing. Eyelash infestations typically result from self-transfer: an individual touches an infested area, like the pubic region, and then touches their eyes. In children, who may not engage in sexual activity, infestations can occur if they share a bed or personal items with an infested adult.
Identifying the Signs and Symptoms
Detecting pubic lice in eyelashes requires careful observation, as the lice themselves are tiny. Adult lice, which are small and have a crab-like appearance, are difficult to spot with the naked eye. More commonly, small, whitish-gray oval eggs, known as nits, may be seen firmly attached to the base of the eyelashes. Dark specks resembling dirt or mascara flakes, which are actually lice feces, can also be observed at the lash line.
Individuals with eyelash infestations often experience intense itching at the root of the lash on the eyelid margin. This itching can become more noticeable at night. Other physical symptoms include irritation and redness of the eyelid, a gritty or burning sensation in the eye, and possibly inflammation of the eyelid, medically termed blepharitis. In some cases, eyelashes may appear to clump or stick together.
Effective Treatment Options
Treating pubic lice in the eyelashes requires a careful approach due to the sensitive nature of the eye area. The primary method involves mechanical removal of the lice and nits. This can be done by carefully using fine-toothed combs or tweezers to pluck individual nits and adult lice from the eyelashes. Manual removal is often the first step and can be effective for mild infestations.
For more stubborn infestations, topical treatments can be considered, though medical supervision is often recommended for eye applications. Occlusive agents like petroleum jelly (Vaseline) can be applied thickly to the eyelashes, typically overnight for several days, to suffocate the lice and nits. Over-the-counter permethrin lotions or pyrethrin with piperonyl butoxide are generally not recommended for direct use around the eyes without a doctor’s guidance due to potential irritation.
If over-the-counter methods are ineffective, or if there is severe eye irritation, a healthcare professional may prescribe specific treatments. These might include ophthalmic ointments designed for use near the eyes or, in some cases, oral medications like ivermectin. Avoid using harsh chemical treatments or products not specifically approved for ocular use, as these can cause significant harm to the eyes. Consulting a physician is always advisable when dealing with an infestation in such a sensitive area.
Preventing Future Infestations
Preventing reinfestation and stopping the spread of pubic lice involves several practical steps. Treat all affected body areas simultaneously to prevent reinfection. If a person has pubic lice in their eyelashes, they should also check and treat other areas of coarse body hair where lice may reside, such as the pubic region, armpits, or beard.
All sexual partners and close household contacts, especially children who may have shared a bed, should be examined for infestation and treated if necessary. To eliminate lice from the environment, all bedding, towels, and clothing that may have come into contact with the infested person should be washed in hot water, at least 130°F (54°C), and dried on a hot cycle. Items that cannot be washed can be dry-cleaned or sealed in plastic bags for at least two weeks to suffocate any remaining lice. Avoiding the sharing of personal items like towels, bedding, and clothing, especially with individuals who might be infested, can also help prevent future infestations.