OutLive
by Michael Stuart

ITCHY & SCRATCHY

The first of a series of STD 101 articles considers lice. Stop scratching

Being sexually active carries with it the risks of infection and infestations, but a rigorous course of safer-sex practices and early treatment can mitigate the consequences. The majority of STD education has traditionally focused on HIV/AIDS, but campaigns to inform on other sexually transmitted diseases have been less vigorous. While many common diseases are easily treated if diagnosed early enough, an ignored infection can lead to severe long-term consequences. The hardest step is addressing the presence of the illness, and trusting your health-care provider to help you get better.

Given the recent alarming rise in STD infections, including HIV, we have decided to present, over the next few months, something of a primer on major sexually transmitted diseases, their symptoms, testing, treatment, and long-term effects. Pay attention.

Mommy, it itches!

For the past few days, you have noticed that you have been scratching a great deal. You always practice safer sex, so the thought of an STD never crosses your mind. Then, as you scratch particularly vigorously, a small flake comes off. You’re curious, so you look closer and notice wriggling legs attached to what you though was a scab. Calm down. Do not bathe in alcohol, hydrogen peroxide, or bleach. Yes, it could be lice.

Lice alert

There are three different species of human lice, Pediculus humanus corporis, Pediculus humanus capitus, and Phthirus pubis. The lice of the genus Pediculus are very similar in shape, size, and coloration, and consist of those lice that infest head hair and the fine hairs that cover our bodies. Body lice are relatively uncommon, but unsanitary living conditions or close quarters—elementary schools, for example—can lead to an outbreak of infestations. Many families with young children suffer through at least one infestation of head lice, which often requires the treatment of the entire household.

Pubic lice, Phthirus pubis, look like miniature crabs that latch on to the coarse hair in the pubic region, as well as chest and arm pit hair. While sharing a towel or dirty sheets can transmit pubic lice, the majority of transmissions derive from sexual contact.

Symptoms and treatment

Apart from the itching, lice infestation can cause severe skin irritation. Often there is swelling and red papules in the bite area. In an advanced infestation, careful examination shows the formation of small, oblong, white egg casings attached close to the root of hair follicles in the infested region. Extended pubic lice infestation can cause brown pigmentation of the bite areas.

Numerous treatment options are available for each type of infestation, and only your doctor can make an accurate diagnosis of an infestation and recommend an appropriate treatment course. Many over-the-counter pediculicidal lotions and shampoos are capable of killing both pubic and head lice. Be careful to follow the instructions, because many treatments kill only living lice and not their eggs. In such a case, it is crucial that treatment be repeated in two weeks. Extremely important: All potentially exposed sheets, towels, clothing, and blankets must be washed and placed in a hot dryer for not less than 20–30 minutes after each treatment. Vacuum carpets and throw away the vacuum bags. As always, it is your responsibility to your sexual partners to inform them of a sexually transmitted disease in order that they obtain treatment and to prevent the infection of others.

Next column: gonorrhea/chlamydia and syphilis

Michael Stuart reported on the 1986 Bowers v. Hardwick case in the Lawrence v. Texas sodomy-case coverage in our March 2003 issue.

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