Pubic lice — also known as crabs — are small parasites that attach to the skin and hair near your genitals. Crabs are not dangerous and are relatively easy to get rid of, but are very contagious. They are spread by close contact, principally sexual contact, but also by using towels or wearing clothes of an infected person.  


APPOTEK can help you with pubic lice.


There are three types of lice that infest humans – head lice, body lice and pubic lice. 


Lice feed on human blood and cause intense itching in affected areas. Pubic lice usually live on pubic hair and are spread through sexual contact. In rare cases, they can be found in eyelashes, armpit hair, and facial hair. Pubic lice are often smaller than body and head lice. Adult lice lay their eggs on the hair shaft, near the skin. These eggs are called nits. Seven to 10 days later, nits hatch into nymphs and start feeding on your blood. Pubic lice are a parasite and need our blood to survive. Outside the body, they die after about a day.


Itching in the genital region or anus is the most common symptom of pubic lice and is an allergic reaction to their saliva. 


The first time you get crabs, it will start itching after about 4-6 weeks. But if you get pubic lice again, itching starts already after 1-2 days. The itching is usually worse at night because that’s when the lice are most active. Excessive itching may cause wounds or an infection in the affected areas. 


Other common symptoms of pubic lice include:


  • low-grade fever
  • irritability
  • lack of energy
  • pale bluish spots near the bites


Pubic lice are usually easy to diagnose by examining the affected area. The lice are very small, about 2–3 millimeters and usually a pale brownish colour. You’re probably infested with lice if you see small, crab-shaped insects moving in your pubic hair.


Lice eggs are another indicator of infestation. The eggs look like small white grains and are usually found around the roots of pubic hair. Sometimes they can also be found in armpits, in the beard and eyebrows as well as on eyelashes.


Children with lice infestations on their eyelashes are also at risk of developing conjunctivitis (‘pink-eye’).

Prevention and protection

To prevent a pubic lice infestation, you should avoid sharing clothes, bedding, or towels with anyone who has pubic lice. Sexual contact should also be avoided until treatment is complete and successful.


Once you’ve been diagnosed with pubic lice, you must inform all current and past sexual partners so that they can be treated as well.


Washing your clothes and towels in a washing machine at 60 degrees will kill the lice.


It’s easier said than done – but try not to itch. There is a risk that you will make small wounds that may become infected. 


Treatment for pubic lice consists of decontaminating yourself, your clothes, and your bedding.


There are medicines that both get rid of crabs and relieve itching that can be found at pharmacies. However, you should contact a doctor before starting treatment to be sure that your symptoms are caused by pubic lice. 


A lice-killing lotion containing 1% permethrin or a mousse containing pyrethrins and piperonyl butoxide can be used to treat pubic (“crab”) lice. These products are available without a prescription at pharmacies and are safe and effective when used according to the instructions. Effectiveness of treatment is increased when the pediculicide is left on the skin and hair for at least an hour. A second round of treatment is recommended within the following seven to ten days to kill newly hatched nymphs.


Topical lotions and shampoos can be used to remove pubic lice from your body. Ask your doctor which products are safe to use if you are pregnant or breastfeeding, or are treating an infant for pubic lice.


You may only need to wash your pubic hair if your lice infestation is mild. Prescription medication might also be necessary if the topical solutions don’t work.


Even after successful treatment, a few stubborn lice eggs might cling to your hairs. Remove any leftover nits with tweezers. Home remedies, such as shaving and hot baths, aren’t effective for treating pubic lice. Lice can easily survive ordinary soap and water.


If several people in your household have contracted pubic lice, treat everybody at the same time. This helps prevent reinfection.


You will also need to decontaminate your home. Vacuum the entire house and clean the bathroom with bleach solution. Wash all towels, bedding, and clothing in hot water, and machine dry them using the highest setting. If you can’t wash or dry clean a certain item of clothing, seal it in an airtight plastic sack for 72 hours.


You might need stronger medicine if the lice survive these efforts.

When to consult a doctor

Call your doctor if you’re showing signs of a pubic lice infestation. 


You should also be tested for other sexually transmitted infections (STI’s) if you have pubic lice through sexual contact.

How APPOTEK can help

APPOTEK can help you with pubic lice. In the initial consultation, a nurse or a physician will evaluate your symptoms, then may prescribe treatment or refer you for further examination.


Valeria Chernikova, Neurologist, M.D.