Pubic lice, also known as crabs, are very small insects that infest your genital area. There are three types of lice that infest humans:
- pediculus humanus capitis: head lice
- pediculus humanus corporis: body lice
- phthirus pubis: 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.
Pubic lice infestations are more common among people who have sexually transmitted infections.
Pubic lice are typically transmitted through intimate contact, including sexual intercourse. It’s also possible to catch pubic lice by using the blankets, towels, sheets, or clothing of people who have pubic lice.
Adult lice lay their eggs on the hair shaft, near the skin. These eggs are called nits. Seven to 10 days later, the nits hatch into nymphs and start feeding on your blood. The lice can live without their food supply for one to two days.
Contrary to common belief, you’re highly unlikely to get pubic lice from a toilet seat or furniture. Pubic lice usually don’t fall off of their host unless they’re dead. They also can’t jump from one person to another like fleas.
Don’t allow your children to sleep in your bed if you have a pubic lice infestation. Children may get an infestation after sleeping in the same bed as someone who has pubic lice. In children, the lice usually live in their eyelashes or eyebrows. The presence of pubic lice in a child might also indicate sexual abuse.
People with pubic lice often experience itching in their genital region or anus about five days after the initial infestation. At night, the itching will become more intense. Other common symptoms of pubic lice include:
- low-grade fever
- lack of energy
- pale bluish spots near the bites
Excessive itching may cause wounds or an infection in the affected areas. Children with lice infestations on their eyelashes are also at risk of developing conjunctivitis (pink eye).
You can usually diagnose yourself by thoroughly examining your pubic area. You can use a magnifying glass to look for pubic lice if you suspect an infestation but can’t see well enough to be sure.
Lice are usually pale gray, but they can darken in color after drinking your blood. 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 are tiny and white, and are usually found around the roots of pubic hair or other body hair.
Call your doctor if you’re showing signs of a pubic lice infestation but aren’t completely sure that you have one.
Treatment for pubic lice consists of decontaminating yourself, your clothes, and your bedding.
Topical, over-the-counter lotions and shampoos can be used to remove pubic lice from your body. These treatments include RID, Nix, and A-200. Ask your doctor which products are safe to use if you are pregnant or breast-feeding, or are treating an infant for pubic lice. You may only need to wash your pubic hair if your lice infestation is mild. Read the instructions to find out exactly how much product you should use and how long you’ll need to leave the product on your skin. 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. These products include:
- Malathion (Ovide), which is a topical lotion that you leave on the affected areas for eight to 12 hours.
- Ivermectin (Stromectol), which is a two-pill dose that you take orally. You might need a follow-up dose 10 days later.
- Lindane, which is the strongest and most toxic product among the commonly prescribed pubic lice medications. You only leave it on for four minutes before washing it off. Don’t use this product on infants or on yourself if you’re breast-feeding or pregnant.
For pubic lice in eyelashes, apply petroleum jelly to the lashes and eyelids three times a day for a few days. Alternatively, you can pluck the nits and lice with tweezers. Your doctor might prescribe a special lice medicine suitable for the eye area. Don’t use regular lice shampoos around the eyes.
Itching may persist for a week or two as your body works through its allergic reaction to the bites. Call your doctor if you notice swelling, skin discoloration, or drainage from wounds.
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.