Pubic Lice (Crabs)

Straight to the Facts: Crabs

  • Caused by intimate contact with an infested person

  • Lice are small, but you will be able to see them

  • Symptoms include:

    • Itching in the genital area

    • Visible nits/eggs

    • Crawling lice

    • Blood spots in underwear

  • Most commonly found in pubic hair, but can be found in facial hair, eyebrows, chest hair, back hair, and armpits

  • Treated with over-the-counter lotions containing permethrin/pyrethrins and piperonyl butoxide

  • Not treating can lead to open wounds which could become infected

Pubic lice are a parasitic infection caused by an insect called Phthirus pubis. It is a common STI with an estimated 3 million cases every year in the US. It is spread by sexual contact or by sharing clothing or beds with infested people. It is not a reflection of your hygiene and it is not caused by the same insect that causes head lice.


Pubic lice do not carry disease, but if you scratch your skin a lot it can lead to a skin infection or increase your risk for other STIs. Pubic lice can also be treated with both prescription and over-the-counter medications and by washing clothing and bedding in hot water.


How Do I know I have it?


Signs and symptoms of pubic lice include itching in the genital area, visible nits, which are eggs, or crawling lice. Less commonly, lice can also be found in facial hair, eyebrows, chest hair, back hair, and armpits.

How can I get it?


Pubic lice are usually spread through sexual contact and are most common in adults.  Occasionally, pubic lice may be spread by close personal contact or contact with items such as clothing, bed linens, or towels that have been used by an infected person.


How can I get treated?


Lice can be cured with the right treatment. Use an over-the-counter lice-killing lotion with 1% permethrin or a mousse containing pyrethrins and piperonyl butoxide to treat lice found at a local drug store or pharmacy. These products are safe and effective when following the instructions exactly on the package or label.


Another form of treatment is Lindane shampoo. Although not recommended as the first line of defense, Lindane shampoo is available as a prescription medication and kills lice and lice eggs. Other prescription treatments are available from your healthcare provider if you do not respond to other treatment options.


Usually, treatment is as follows:

  1. All sexual partners must be treated at the same time.

  2. Shower and towel dry yourself.

  3. Following the directions on the box or insert, apply the lice treatment or prescription. Be sure to fully saturate the pubic hair and any other part of your body where pubic lice live.

  4. Follow up the treatment by using a fine-tooth comb to remove nits. Nits will stick to your hair even after treatment, so it is important not to skip this part. Fine-tooth combs are available from the pharmacy.

  5. Put on clean underwear and clothing.

  6. Wash any clothing, towels, and bedding you have used in the last 2-3 days. Wash them in hot water, at least 130 degrees Fahrenheit, and dry in the highest heat you have.

  7. Any clothing that cannot be washed should be dry-cleaned or bagged for at least 2 weeks.

  8. Repeat the treatment in 8-10 days if you think you still have lice.

  9. Get checked for other STIs!


What happens if I do not get treated?


Untreated pubic lice can lead to a large infestation and can result in infected wounds from constant scratching. It can also increase your risk for other STIs.

Thank you for your question! You should expect an answer within the next 24 hours.