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Pubic lice symptoms and treatment

Pubic lice, also known as crabs, are tiny insects found on coarse body hair, typically in your genital area. They are usually passed on through sexual activity. It is also possible to catch them from hugging or kissing an infected person.  

Pubic lice cannot be prevented from spreading during sex – even by using condoms.  

Infestation is not usually serious, but it’s important to see a healthcare provider. You may need treatment to avoid minor complications such as an infection from scratching or eye irritation.  

What are pubic lice?

Pubic lice, also known as crabs – are tiny insects that live on coarse human body hair, such as pubic hair (the hair around your genitals). They are very small, roughly 2mm long, but are visible, as are their eggs (called nits). Louse can sometimes be found in other body hair such as underarm hair and beards. They are a different type of louse from head lice and body lice. Pubic lice are sometimes called crabs because their bodies look like tiny crabs. 

Pubic lice need human blood to survive, so will only leave the body to move from one person to another. They crawl from hair to hair, they can't fly or jump. 

How do you get pubic lice?

Pubic lice can be passed on easily through being in close contact with the body of someone who has them. They are most commonly spread through sexual activity, including vaginal, anal or oral sex. 

You can also get them from close contact (like hugging and kissing) with someone who has lice. There is a small chance of passing infection on through sharing clothes, towels and bedding with an infected person, but this is much less common.  

How do I protect myself against pubic lice?

The only way to prevent a public lice infestation is to avoid having any close or sexual contact with someone who has lice. This includes sharing towels, bedding or clothing.  

Using condoms or any other methods of barrier contraception won't protect you.

What are the symptoms of pubic lice?

If you have pubic lice you may experience intense itching in your genital region which can spread to other areas with course body hair. It can be several weeks before any symptoms appear. 

Symptoms for women and men include: 

  • itching – the most common symptom and usually worse at night when the lice are most active 

  • inflammation and irritation caused by scratching  

  • black powder in your underwear  

  • blue spots or small spots of blood on your skin, such as on your thighs or lower abdomen (caused by lice bites). 

How do I test for pubic lice?

A healthcare professional can easily diagnose public lice with a simple examination. They may use a magnifying glass to look for signs of live lice or their eggs (nits). 

If you have pubic lice, you should be tested for other STIs. The lice don't transmit HIV or other STIs, but a check-up is a good idea as a precaution.  

It’s also important to tell the people you live with, other people you have been in close bodily contact with and your recent sexual partner(s). They should be checked and treated too, even if they don’t have symptoms. This is important to stop the lice being passed on, and to stop you from getting them again. 

How are pubic lice treated?

Pubic lice can be treated at home with insecticide cream, lotion or shampoo without a prescription. A pharmacist can advise you about which treatment to use and how to use it. Treatment will normally need to be repeated 7 days later to catch all the remaining lice that may have hatched. You may need to use an alternative treatment if there are still lice after this time. 

Certain groups, such as young people under 18 years of age and pregnant or breastfeeding women may require a specific type of treatment. Your healthcare provider can advise on this. 

You should wash all clothes, towels and bedding in hot water (at 50°C or higher) when you start treatment. If there are some things that you can’t wash, put them in an airtight bag for three days. 

Don’t have sex or close body contact with other people until you and your current sexual partner/s have finished your treatment. You will need a check-up to make sure the lice have gone. 

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Are there any additional complications of pubic lice?

Untreated, long-standing infestations can cause you to feel generally unwell. 

Occasionally, a pubic lice infestation can lead to minor complications. These include skin or eye problems. Scratching can lead to an infection such as impetigo (a bacterial skin infection) or furunculosis (boils on the skin). 

Eye infections and eye inflammation can sometimes develop if your eyelashes have been infested with pubic lice. Eyelash infestations are rare though. If your eyelashes are infested, seek specialist advice from a healthcare professional. 

Is there a link between pubic lice and HIV?

Pubic lice don’t carry other diseases, and although they feed on blood, pubic lice cannot pass on HIV or other STIs. 

If you are taking antiretrovirals (ART), it is important to tell your doctor. They can advise how treatment for pubic lice may interact with your HIV drugs. 

How do I tell my recent sexual partner(s) I have pubic lice?

If you find out you have pubic lice it’s important to tell any recent sexual partner(s). Then they can also get tested, and treated if necessary. If you feel it is safe to do so then telling a partner is the responsible thing to do. It shows you respect them and want them to stay healthy. 

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  • Last updated: 18 March 2022
  • Last full review: 01 March 2022
  • Next full review: 01 March 2025
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