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What causes itching from pubic lice?

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Itching associated with pubic lice (Phthirus pubis) is caused by the louse feeding on the blood of the host.12

These insects attach themselves to the base of the hair in the pubic and perianal regions to feed. This process leads to inflammation of the skin, which can result in intense itching and, in some cases, eczema. Individuals typically become aware of the infestation when they notice the lice or their eggs (nits) attached to the hair, or when the itching develops, which generally occurs two to three weeks after the initial infestation.12