Pubic Lice (Crabs): Symptoms and Treatment

Pubic lice, often called “crabs,” are tiny insects that live in coarse body hair. They are common, harmless in the long run, and easy to treat. If you have just found out you have them, it is natural to feel embarrassed, but pubic lice say nothing about your cleanliness, and they clear up reliably with the right approach. Here is what to know.

Pubic lice are different from head lice and body lice. They prefer the coarser hair of the genital area, though they can occasionally settle in other coarse hair such as the abdomen, chest, armpits, beard, or eyelashes. Understanding how they behave makes them much easier to deal with.

For related symptoms, testing and treatment, see our guide to STD Symptoms: What to Look Out For.

What pubic lice are

Pubic lice are small, six-legged insects that grip onto hair close to the skin and feed on tiny amounts of blood. The adults are about the size of a pinhead and can be hard to spot. They lay eggs, called nits, which attach firmly to the base of hairs. The whole life cycle plays out on the body, which is why treatment focuses on the hair and skin where they live.

How they spread

Pubic lice spread mainly through close body contact, including sex. Less commonly, they can pass via shared bedding, towels, or clothing. They are not a sign of poor hygiene, and they cannot jump or fly; they move by crawling, so they need close contact to spread. Because skin-to-skin closeness is the main route, condoms do not prevent them.

Anyone can get pubic lice. Having them simply means you have had close contact with someone who had them, sometimes before either of you noticed any symptoms.

Symptoms

• Itching in the affected area, often worse at night when the lice are more active.
• Tiny lice or pale eggs (nits) attached to hair, sometimes easier to see with a magnifying glass.
• Sometimes small blue spots or specks on the skin from bites.
• Occasionally, dark specks (lice droppings) in your underwear.
• Mild irritation or redness from scratching.

Symptoms may take a week or more to appear after you first pick up lice, so you can carry them for a while before noticing. Itching is the most common sign that prompts people to look more closely.

Treatment

Pubic lice are treated with over-the-counter or pharmacy lotions and shampoos designed to kill them. Follow the product instructions carefully and apply to all affected areas. You will usually repeat treatment after about a week to catch any lice that hatched from surviving eggs, and you should wash bedding, towels, and clothing on a hot wash. Items that cannot be washed can be sealed in a bag for a few days. Partners should be treated at the same time, even if they have no symptoms, to avoid passing the lice back and forth.

Lice on the eyelashes need special care; do not put regular lotions near the eyes. A pharmacist or clinician can advise on the safest option. If itching continues after correct treatment, or if the skin looks infected from scratching, check back with a professional.

Prevention

There is no foolproof prevention since they spread by close contact (condoms do not prevent them), but avoiding close contact during treatment and washing shared items helps stop them spreading or coming back. Telling recent partners lets them get treated too, which breaks the cycle. If you have one sexually transmitted infection, it is worth a full check-up, since infections can travel together and it is reassuring to know where you stand.

While you are being treated, it makes sense to avoid sharing towels, bedding, and clothing, and to hold off on close physical contact until you and any partners have completed treatment. These simple measures stop the lice traveling between people or surfaces and make reinfestation much less likely.

How pubic lice differ from other lice

It is easy to confuse the different kinds of lice, but they are not interchangeable. Head lice live on the scalp and spread among children at school; body lice live in clothing seams; and pubic lice prefer the coarser hair of the genital area. Because they live in different places and behave differently, a treatment or assumption that applies to one does not automatically apply to another. Knowing which you are dealing with helps you choose the right treatment and avoid unnecessary worry. Pubic lice, despite their unsettling nickname, are among the most straightforward to clear once you treat them properly. Because the three kinds rarely overlap, getting pubic lice does not mean you will also pick up head or body lice, and the same is true in reverse.

When to see a clinician or pharmacist

Most cases can be handled with a pharmacy treatment, but it is worth getting professional advice if you are pregnant or breastfeeding, if the lice involve the eyelashes, if symptoms persist after correct treatment, or if the skin becomes broken, weepy, or infected from scratching. A pharmacist can recommend a suitable product and explain how to use it, while a sexual health clinic can check for other infections at the same time. Asking for help is sensible, and these services deal with pubic lice routinely and without judgment.

FAQ

Do pubic lice mean I am not clean?

No. Pubic lice spread through close contact and have nothing to do with hygiene. Clean, well-groomed people get them just as easily as anyone else.

Will condoms protect me from pubic lice?

No. Because pubic lice live in hair and spread through skin and hair contact, condoms cannot prevent them, even though condoms remain important for preventing many other infections.

Does shaving get rid of pubic lice?

Shaving alone is not a reliable treatment. Lice and nits cling tightly to hair, and removing some hair will not clear an infestation. Use a proper treatment lotion or shampoo as directed.

How long until the itching stops?

Itching can linger for a short while even after the lice are gone, as your skin settles. If it persists beyond the expected treatment course, or worsens, speak with a pharmacist or clinic.

Should my partner be treated even without symptoms?

Yes. Symptoms can take time to show, so a partner may carry lice without itching yet. Treating together at the same time prevents you reinfecting each other.

A pharmacist or clinic can advise on the right treatment for you.

This article is for general information and is not medical advice.