3 causes of pubic itching – and how to deal with them.

pubic itching, itchy pubes,If you’re suffering with the embarrassment of an itchy pubic area, diagnosis and treatment probably can’t come soon enough.  In this article we’re going to look at the problem, the possible causes and treatments.

This type of itching is confined to the area over the front and outer part of the pubic area – mainly where the pubic hair is growing (or would grow if you’ve had it removed) – and around the anal area.

It can be an intense itch or a mild but repeated itch.

For information on vaginal itching, see this article.

1. Pubic lice.

Lice are tiny 6-legged bugs that can live anywhere on the body.  They prefer thicker, course hair, which is why they are common in the pubic area (but can also be found in the armpits, eyebrows, beard, eyelashes, chest and head hair).

They:

  • are about 1-2mm long – smaller than the head of a match
  • are grey or brown in colour.
  • The female lays eggs that are smaller than a pinhead in the hair. She can lay up to 300 in 1-3 months. The eggs are light/white in colour.
  • These hatch after about 6-10 days.

What are the symptoms of pubic lice?

Itching that starts shortly after infection with lice, or may not start for 2-4 weeks.

Pubic itching is often worse at night.

Sore in the pubic/genital area that are caused by bites or scratching.

A skin reaction to the lice, causing the skin to be a blue-grey colour (not everyone gets these last 2 symptoms).

What tests will the doctor do for pubic lice?

The doctor will examine the pubic area and be able to see the lice/eggs.  These are visible under a microscope if they’re not seen by the naked eye.

Pubic lice are a sexually transmitted problem (see below) so it’s a good idea to get checked for other STDs at the same time.

What is the treatment for pubic lice?

Washing the hair isn’t enough.  The lice need to be dealt with by an insecticide lotion or cream.

Permethrin is one of the chemical names you need to look for and it is contained in specialist products such as Elimite or Kwell or Lyclear.  These aren’t suitable for under 18s, breastfeeding or pregnant mothers.

Malathion is another chemical name (eg contained in Derbac-M) but these preparations aren’t suitable for everyone.

Experts recommend that you use the preparation (it’s a cream or lotion) all over the body, not just the pubic/anal area because the lice can move on the body.

How to use treatments for pubic lice:

  • Follow the directions given but generally, use 100ml or 20-30g of cream for each treatment (you will need 2 treatments, 7 days apart).
  • Apply the lotion/cream to cool, dry skin.  If you’ve had a bath or shower make sure the skin is cooled and completely dry before you begin.
  • Refer to the instructions for the time that the treatment needs to be left on the skin.  For malathion it’s usually 12 hours and for permethrin it’s 24 hours.
  • Make sure you don’t get the chemicals in your eyes if you’re applying to the face.
  • Repeat the treatment 7 days later.  Most of the lice will have been killed in the 1st treatment but the eggs may not have been, so this second treatment will make sure that the problem is dealt with.
  • You may want to also wash bed linen and towels in a hot wash.  Some experts feel this is not necessary.

What causes pubic lice?

Pubic lice are transmitted by close physical contact – usually sexual contact.

Very rarely they can be caught from infected bedding, towels or clothes.

What’s the outcome for people with pubic lice?

Once the treatment is complete then there should be no further problems.  Sometimes intense scratching can cause the skin to break and a bacterial infection can get in, but this can be treated with antibiotics if necessary.

Sexual partners also need to be treated.  If you’re not comfortable contacting people you’ve had sex with then this can be done anonymously but an STD clinic.

2. Jock itch.

Jock itch (also called Dhobi itch, crotch rot, gym itch, jock rot) is caused by a fungal infection in the skin of the groin area.

What are the symptoms of jock itch?

  1. Itching in the groin area, the anal area and/or the skin folds of the thigh.
  2. The skin may appear lighter or darker in colour.
  3. There are usually red, raised circular patches of scaly skin.  They have a dark red outer rim and paler red or normal skin colour inside the patch.  These patches may blister and ooze fluid.

What tests will the doctor do for jock itch?

An examination of the skin is usually all that is needed and tests won’t be required unless the doctor thinks there is another cause for the problem.

What is the treatment for jock itch?

  • Keep the area clean and dry.
  • Wear loose clothing that doesn’t rub the skin and irritate the area.  Also wear natural fibres (cotton, wool) that let the skin breath and won’t trap sweat.
  • Use powders, sprays or creams that contain miconazole (brand examples are Monistat, Vusion), tolnaftate (eg Mycil) or clotrimazole (eg Mycelex, Lotrisone).  These are anti-fungal chemicals that will treat the infection. They are available over the counter at the pharmacy.
  • Wash undergarments in a hot wash (60C/140F) to kill the fungus and prevent re-infection.
  • If the infection doesn’t clear up within 2 weeks, is severe, or keeps coming back then you should see your doctor for prescription-strength antifungal meds.

What causes jock itch?

The fungus that causes it lives in warm damp areas.  If you do a lot of sport and don’t wash often, change your clothes or wash them at a hot temperature, this can make the right conditions for jock itch.

Alternatively if you’re overweight then extra skin folds can contribute to the environment the fungus needs to thrive.

If you have a fungal foot infection (athlete’s foot) or ringworm, jock itch often accompanies these conditions.  Treat all the conditions at the same time.

Who gets jock itch?

It’s most common in teenage boys and young men.  But wherever the conditions are right (see above), the infection can occur in anyone.

It can be contagious so avoid close body contact with others until the infection is treated and keep your clothes and towels separate from others’.

What’s the outcome for jock itch?

It can be successfully treated at home (see above) but can re-occur.

How can I prevent jock itch?

  • Wash and dry the skin daily and after sport.
  • If you’re over weight and have excess skin folds then losing weight will help.
  • Don’t share undergarments, sports gear and towels.
  • Wear loose fitting, natural fibre clothing that doesn’t rub the area.
  • If you’ve had jock itch a few times, use an antifungal powder after washing.

3. Lichen simplex chronicus.

This skin problem causes a long term itching-scratching cycle that can be hard to break.

What are the symptoms of Lichen simplex chronicus?

  • Whatever the trigger (an insect bite, skin condition or irritation from clothing – see below) this sets off an itch-scratch cycle.  This means that the more you scratch the more the skin itches and so on.
  • This can happen on any part of the body, including the pubic/anal area.
  • The skin becomes thick and scaly in places where the itch/scratch occurs.
  • These patches may appear leathery or brown.
  • The itching may be worse with anxiety or stress.
  • There may be raw areas and scratch lines on the skin.

What tests will the doctor do for Lichen simplex chronicus?

The doctor will examine the skin and may do a skin biopsy to determine what’s causing the itching.

What is the treatment for Lichen simplex chronicus?

  • A steroid cream or lotion can help reduce the inflammation or itching if there is an underlying skin condition.
  • Ointments containing salicylic acid help the skin peel and renew itself if they skin patches are very thick.
  • Soaps and lotions containing coal tar can help calm the skin.
  • Your healthcare provider may recommend that the skin lesions are covered with a dressing, especially if there are raw patches or open wounds that may become infected.
  • Creams and lotions can also be left in place under a dressing.
  • Antihistamine creams, gels or tablets also help reduce itching.
  • To break the itch/scratch cycle it’s important to stop scratching, but this is easier said than done.  Psychological support and counselling may be useful for this, with/without antidepressants etc.

What causes Lichen simplex chronicus?

It’s more common in people who have psoriasis, eczema or a psychological problem such as anxiety or depression.  An itchy skin problem, such as an insect bite, itchy clothing or skin condition can start the itch-scratch cycle.

What’s the outcome for Lichen simplex chronicus?

Once treated it should calm down, and good control of any underlying skin problem is essential. It can return.

If you’re worried about your symptoms or medical problem but don’t want to seek professional help because you feel embarrassed, silly or that it’s your fault in some way, read this page now:  How to talk to a doctor about an embarrassing problem.

Elspeth Raisbeck 

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