concern of

I have a concern in the what you think the odds are that I contracted to crabs. I had a massage at an asian massage parlor and 2-3 days after I became itchy in the genital area.  I was nude on the massage table so I wonder if i may have caught it from the towel that was underneath me.  In many things I read it says that it usually takes 5 days for symtoms (symptoms) to become noticeble.  Prior to this I would have itching in the scrotum area from time to time and it wasnt to pronounced.  What has me concerned is upon the scare ,  I have scene tiny white specs very few and in  in the pubic hairs , they are generall at the tops of the hair not the base , however they shake off and come off very easy so im wondering if this is dry skin. I have also read that nits are generally at the base of the pubic hair , They say the eggs of lice attach to the pubic hair and you have to slide them across the hair follicle and they dont just wipe off . I went to the dr after trimming the pubic hair and he said he didnt see anything he thought it was jock itch and put me on a cortizode steroid which is helped a bit , I have been taking it for 6 days now . I do see white specs from time to time but they come right off. Is it possible the Dr misdiagnosed me ? and that I trimmed on the nits so he didnt see them.  I have had sex with my wife over the past 3 weeks since the concern and she's not itchy at all . I would think that hypothetically speaking If I had them she would have them by now . should I be concenred please advise.     Can you comment on the incubation period and is it possible for symptoms to come out a couple days after an exposure, I dont have any bite marks or see any crabs but im wondering if what i see is dry skin or nits. Can the cortizode steroid cause burning and itching as well . Please share your thoughts with me

[Jasmina Jankicevic, MD, MSc, CCRP]

Welcome to the Dermatology Expert Forum! You are well informed about Phthiriasis pubis (pubic lice) and it does not sound like you have it.

To answer your question about "incubation period" first: Symptoms of Phthiriasis pubis can appear very early, if patient was infested with adult louse. Still, symptoms usually intensify after 7 days (incubation period of eggs of pubic louse).

Next, you mentioned jock itch. Two primary causes of jock itch are excess moisture and fungal infection. Therefore, primary local medication for it would be an antifungal cream. For skin irritation, it is important to keep the area clean and completely dry, and use underwear made of cotton.

Finally, about topical corticosteroid creams/ointments: They have anti-inflammatory properties and should have calming effect on burning and itching unless there is an allergic reaction to particular formulations. However, monotherapy with local corticosteroids is not recommended in fungal skin infections (it will not treat the cause of problem and prolonged use may aggravate fungal infection ).

Wishing You Optimal Health,
Dr. Jasmina Jankicevic