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Overview

What Are Pubic Lice?

Pubic lice are tiny parasitic insects that usually live in coarse body hair, especially pubic hair. Sexual contact is a common way they spread, but close body contact or recently used clothing, towels, or bedding can also play a role. Anyone can get pubic lice, and having them is not a sign of poor hygiene. They are often called pubic crabs or crab lice because of their crab-like shape.

Symptoms

Symptoms of Pubic Lice

Symptoms of pubic lice may begin days to weeks after exposure, although some people have few or no symptoms. Common signs include itching, visible lice or eggs, and irritated skin. Itching or a rash can have many causes, so these symptoms alone do not confirm pubic lice.

  • Intense itching.
  • Visible crawling lice.
  • Whitish or yellow-gray eggs firmly attached to hair (nits).
  • Small red or bluish spots from bites.
  • Scratch marks or irritated skin.

IMPORTANT

Check other body hair

Lice or nits can also occur in armpit, chest, beard, eyebrow, or eyelash hair. Eye-area involvement needs clinician guidance rather than routine self-treatment.

How It Spreads

How Pubic Lice Spread

Pubic lice usually spread through close body-to-body or sexual contact when infested hair touches another person’s hair. They do not jump or fly, and ordinary brief contact is not the usual route of transmission.

  • Close sexual contact can spread pubic lice when infested hair touches another person’s hair.
  • Less commonly, recently used clothing, towels, or bedding may spread pubic lice.
  • Contact with infested hair can spread lice to other body-hair areas.

Risk Factors

Risk Factors for Pubic Lice

  • Recent sexual or close body contact with someone who has pubic lice increases exposure risk.
  • Having a new sexual partner can increase the chance of encountering an infested person.
  • Having multiple sexual partners can increase opportunities for exposure.
  • Sharing recently used bedding, towels, or clothing can occasionally spread pubic lice.

Complications

Possible Complications

  • Scratching can break or irritate the skin.
  • Broken skin can develop a secondary bacterial infection.
  • Infestation can persist after incorrect treatment or untreated contacts.
  • Eyelash involvement may require clinician-directed care.

SEXUAL HEALTH

Consider STI testing

A diagnosis of pubic lice may be an opportunity to discuss testing for other sexually transmitted infections, depending on your exposure and symptoms.

Diagnosis

How Pubic Lice Are Diagnosed

Diagnosis is usually made by examining affected hair and skin for live lice or firmly attached nits. A clinician may use magnification or a fine-toothed comb to help identify the insects and distinguish them from debris or other causes of itching.

  • Inspect pubic and other affected body hair.
  • Ask about symptoms and close contacts.
  • Distinguish nits from debris or other skin conditions.
  • Offer testing for other sexually transmitted infections when appropriate.

Treatment & Management

Treatment and Management

Pubic lice are usually treated with a topical insecticide. A pharmacist or clinician can recommend an appropriate product, such as a permethrin- or pyrethrin-based treatment; follow the package directions exactly. This approach is often used as an over the counter medicine for pubic lice, but special situations may require medical advice.

SituationTypical approachWhen to seek advice
Typical pubic or body-hair infestationUse an appropriate over-the-counter topical treatment exactly as directed.Ask a pharmacist or clinician if you are unsure which product to use.
Eyelash involvement, pregnancy, or breastfeedingUse clinician-directed care rather than routine self-treatment.Seek advice before applying any lice medicine.
Persistent infestation or treatment failureHave the diagnosis and treatment plan reviewed.Contact a clinician if live lice remain after correctly following instructions.
Remaining nitsUse a fine-toothed comb to remove nits when advised.Ask for guidance if eggs remain or the infestation returns.
  • Treat current sexual or close contacts as advised.
  • Avoid sexual or close body contact until treatment is complete and contacts have been treated.
  • Wash recently used clothing, bedding, and towels according to label guidance.
  • Seal items that cannot be washed in a bag as directed.
  • Do not use household insect sprays.

USE TREATMENT SAFELY

Protect the eyes

Do not apply lice medicine to the eyes. Seek clinician guidance for eyebrows or eyelashes, children, pregnancy, breastfeeding, or symptoms that remain after correctly following treatment instructions.

Prevention

Preventing Pubic Lice

  • Avoid sexual or close body contact with an infested person until treatment is complete.
  • Notify recent sexual or close contacts so they can seek advice and treatment if needed.
  • Do not share towels, clothing, or bedding.
  • Wash or isolate recently used items as directed.

Outlook and Prognosis

Outlook for Pubic Lice

Pubic lice are usually curable with appropriate treatment and contact management. Itching or skin irritation may take some time to settle after the lice are gone. New exposure or untreated contacts can cause reinfestation.

  • Check for live lice after treatment as directed.
  • Repeat treatment only when product instructions or a clinician recommends it.
  • Seek reassessment if live lice remain.
  • Understand that new exposure can cause reinfestation.

When Should You See a Doctor

When Should You See a Doctor?

  • You are unsure whether your symptoms are pubic lice.
  • Live lice remain after you correctly followed treatment instructions.
  • Lice affect the eyelashes or eyebrows.
  • The skin is increasingly painful or appears infected.
  • You may have been exposed to another sexually transmitted infection.

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