Pubic lice

Pubic lice are parasitic insects that feed on human blood. They are short and crab-like and look very different from head and body lice. Pubic lice typically attach to hair in the pubic area. Adult pubic lice are 1.1–1.8 mm in length (size of a pencil tip).

About Pubic “Crab” Lice

Pubic lice are parasitic insects that feed on human blood. They are short and crab-like and look very different from head and body lice. Pubic lice typically attach to hair in the pubic area. Adult pubic lice are 1.1–1.8 mm in length (size of a pencil tip).

Either over-the-counter or prescription medications can treat pubic lice infestations. Infestation or infested person means that a person has lice.

Symptoms

Signs and symptoms of pubic lice include:

• Itching in the genital area
• Visible nits (lice eggs)
• Lice crawling or attached to pubic hair
• Lice in other hairy areas (eyelashes, eyebrows, beard, mustache, armpits, chest, back)

Pubic lice do not transmit disease. However, you could get sores and a bacterial infection from intense scratching.

Who is at risk

Anyone can get pubic lice. Pubic lice usually spread through sexual contact and are most common in adults.

How it spreads

You usually get pubic lice from intimate, person-to-person contact, usually sexual contact. Occasionally pubic lice can spread by clothing, bedding, or (very rarely) using a toilet seat that was just used by a person infested with public lice.

Adult pubic lice are found only on humans and require blood to survive. They will die within 24 – 48 hours without a blood meal. Female adult pubic lice lay about 30 eggs during their 3 – 4-week life span. Eggs hatch after about a week. Nymphs (newly hatched lice) mature into adults over 6 to 9 days.

Animals do not get or spread pubic lice.

Pubic lice found on the head or eyelashes of children may be an indication of sexual exposure or abuse.

Prevention

The following are steps that can help prevent and control the spread of pubic (“crab”) lice:

• Examine yourself and seek treatment if you experience any of the symptoms of pubic lice or a sexual partner has recently had pubic lice.
• All sexual contacts should be examined. All those who are infested should be treated.
• Avoid all sexual contact with others until treatment is successful.
• Machine wash and dry worn clothing and used bedding by the infested person in the hot water (at least 130°F) laundry cycle and the high heat drying cycle. Dry clean clothing and items that are not washable OR seal them in a plastic bag and store them for two weeks.
• Do not share clothing, bedding, or towels used by a person infested with pubic lice.
• Do not use fumigant sprays or fogs; they are not necessary to control pubic (“crab”) lice. They can be toxic if inhaled or absorbed through the skin.

Diagnosis

Pubic lice infestation is diagnosed by finding a “crab” louse or nits on hair in the pubic region or, less commonly, elsewhere on the body. These areas include the eyebrows, eyelashes, beard, mustache, armpit, groin, torso, scalp, or anus. Pubic lice are short and crab-like; they appear very different from head and body lice (I.e., they are broader and flatter than other lice). Although pubic lice and nits can be large enough to see with the naked eye, a magnifying lens may help to see them.

Lice found on the head generally are head lice, not pubic lice.

If you are unsure about infestation or if treatment is not successful, see a healthcare provider for a diagnosis. Consider getting tested for other sexually transmitted diseases (STDs).

Treatment and recovery

You can treat pubic lice with a lice-killing lotion containing 1% permethrin or a mousse containing pyrethrins and piperonyl butoxide.

These products are available over-the-counter without a prescription at a local drug store or pharmacy. These medications are safe and effective when used exactly according to the instructions in the package or on the label.

Pubic lice

Pubic lice are very small (2mm long) and grey-brown in colour.

They can be hard to spot, but sometimes you may be able to see them in your hair.

They most often live on pubic hair around the penis or vagina, but can also be found in hair on the chest, armpits, face and eyelashes. They do not affect hair on the head.

Other symptoms of pubic lice include:

• itching, which is usually worse at night
• small red or blue spots on your skin (lice bites)
• white/yellow dots attached to your hair (lice eggs)
• dark red or brown spots in your underwear (lice poo)
• crusted or sticky eyelashes, if they’re affected

Non-urgent advice: Go to a sexual health clinic or see a GP if:

• you think you might have pubic lice

Pubic lice will not go away without treatment.

If you’re sure you have pubic lice, you may be able to get treatment from a pharmacist.

What happens at your appointment

If you go to a sexual health clinic or GP surgery because you think you have pubic lice, a doctor or nurse will check your hair for lice.

They may check your pubic hair around your penis or vagina and any other areas that could be affected, such as your armpits, chest or eyelashes.

To help spot any lice, they might use a comb and a magnifying lens.

If they think you might have caught the lice during sex, they may ask about your sexual partners. They may also suggest getting tested for any sexually transmitted infections (STIs).

Treatment for pubic lice

The main treatments for pubic lice are medicated creams or shampoos that kill the lice.

You usually need to use the treatment on your whole body and leave it on for a few hours before washing it off. You’ll need to repeat this again a week later to make sure all the lice have been killed.

You may be asked to come back a week after you finish treatment, to check if the treatment has worked.

Any current or recent sexual partners should also be treated, even if they do not have symptoms.

How to stop pubic lice spreading

While you’re being treated for pubic lice, there are some things you can do to help stop the lice spreading to others and stop the lice coming back.

Don’t

How you get pubic lice

Pubic lice are mainly spread by close body contact, most commonly sexual contact.

The lice cannot jump or fly, but can climb from one person to another.

You can also catch the lice from clothes, bedding or towels used by someone with pubic lice, but this is rare.

How to avoid getting pubic lice

It can be hard to prevent pubic lice.

The only way to avoid getting them is to avoid having sexual contact (or sharing bedding or clothing) with anyone you know who has pubic lice, until they’ve been treated.

Condoms and other forms of contraception will not protect you from pubic lice. But it’s still a good idea to use condoms during sex because they reduce the risk of sexually transmitted infections (STIs).

Page last reviewed: 24 May 2022
Next review due: 24 May 2025

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