Pubic Lice (Crabs)

Overview

What are pubic lice?

Pubic lice are also called crabs. These tiny insects live on your pubic hair — the hair below the belly button, around the genitals. Pubic lice rarely live on the scalp, but they can live in other hairy parts of the body, including:

  • Armpits.
  • Beard and mustache.
  • Chest.
  • Eyebrows and eyelashes.

Are pubic lice a disease?

Pubic lice don’t carry or spread diseases. So you can’t get sick from them. But they are annoying and itchy. You may end up with a bacterial infection from scratching. When you scratch, you can break the skin. Bacteria can enter the skin and cause an infection.

Are pubic lice an STD?

Pubic lice often get lumped in with sexually transmitted diseases (STDs). That’s because people get pubic lice most often during sex. But pubic lice are not an actual disease or infection.

How do you get pubic lice?

You get genital crabs by coming into close physical contact with a person who has them. The lice jump from the pubic hair of one person to another. Usually, people catch crabs by having sex with a person who has them. Even if there’s no penetration or intercourse, the close physical contact means you can catch or spread crabs.

You can occasionally get crabs other ways, too. You can catch them by sharing or having contact with the clothes, linens and towels of a person who has them. But you won’t get crabs through casual contact, such as handshakes or hugs.

Can I get crabs by sharing a toilet seat with a person who has crabs?

You most likely cannot get crabs by sharing a toilet seat with someone who has them. The lice can’t live very long when they’re away from a human body. And their legs can’t hold onto a smooth surface like a toilet seat.

What do pubic lice look like?

The lice look different depending on their stage of growth:

  • Nits: These lice eggs are hard to see. They’re usually oval and yellow or white.
  • Nymph: This is the young louse (singular of lice) that hatches from the egg. Each one needs about two to three weeks to become a mature adult.
  • Adult: A fully grown louse has six legs. The front legs are larger and resemble a crab’s pincher claws. Adults are tan or grayish-white.

Nymphs and adult lice feed on blood. Once a louse falls off a person, it dies within a day or two.

Can I get pubic lice from a pet?

No. Dogs, cats and other pets don’t spread pubic lice.

Are pubic lice the same as head lice?

The lice you can get on your head are a different type of lice than pubic lice.

Can children get pubic lice?

Children might get infested if they sleep in the same bed as someone who has pubic lice. Often, pubic lice in a child is a sign of sexual abuse.

How common are pubic lice?

Pubic lice are common, found in people around the world, of every race and ethnic group. Pubic lice are most common in adults. Every year, about 3 million people in the United States get pubic lice.

Symptoms and Causes

What causes pubic lice?

You typically get pubic lice by being physically close to a person who has them. During sex, for example, the lice can jump from your partner’s pubic hair to your own.

Less often, lice spread through shared clothes, towels and linens.

What are the symptoms of crabs?

Pubic lice symptoms often show up about five days after you get infested. Symptoms of crabs include:

  • Pruritus (severe itching) in hairy areas, especially pubic hair.
  • Specks of blood in your underwear.
  • Small white dots on pubic hair that are hard to remove.
  • Pale bluish spots on your thighs, buttocks and lower abdomen.
  • Low fever and feeling run-down.

Why do pubic lice itch?

The lice feed on your blood. They make small bites on your skin. An allergic reaction to the bites causes the itchiness.

Diagnosis and Tests

How can I know if I have pubic lice?

You may see the lice, though they’re small and can be hard to spot. That’s the best way to know for sure if you have them. Pubic lice are the size of a pinhead and look like tiny gray crabs.

How will my provider diagnose pubic lice?

You may have symptoms of pubic lice but can’t see the lice. If you’re not sure, see your healthcare provider for a diagnosis. Your provider may use a magnifying glass to spot the lice. If you have pubic lice, your provider will likely recommend testing for sexually transmitted diseases.

Management and Treatment

What is pubic lice treatment?

You treat pubic lice using a special shampoo or cream. You can typically buy these treatments over-the-counter, without a prescription. They are safe and effective. Make sure to follow the directions on the package carefully

For best results from the lice treatment, follow these steps:

  • Check for lice in your underarm hair and other hairy parts of your body. Wash and dry your body.
  • Apply the shampoo or cream on all the areas that may have crabs — thighs, underarms and trunk (lower abdomen and buttocks, including near the rectum). Do not put it on your eyelashes.
  • Leave the shampoo or cream for the amount of time recommended in the instructions, then rinse it off.
  • Remove nits from hair strands using fingers or a fine-toothed comb. Put on clean underwear and clothing after treatment.
  • Clean your clothes, bed linens and towels using the hot cycles of your washer and dryer. The heat destroys the crabs. Place items you can’t wash in a sealed plastic bag for two weeks. Or get them dry-cleaned.
  • Do not spray insecticide on your clothes or other objects in your house.
  • Pause your sex life until the crabs go away, usually about two weeks.
  • Repeat the treatment in nine to 10 days if the lice remain.

What are the types of shampoos and creams for pubic lice?

Pubic lice treatments that you can buy without a prescription include:

Common brand names of these lice treatments include A-200®, RID® and Nix®.

Are there prescription medications for pubic lice?

If over-the-counter approaches don’t work, you may need a prescription for stronger treatments. Your healthcare provider may recommend a topical cream for your body or a shampoo. Oral medicines (taken by mouth) may provide another option, too. Lice get exposed to these drugs when they bite you and draw blood.

One of the prescription options is called lindane shampoo (Kwell®). It destroys lice and eggs but can have serious side effects. It may be toxic to the brain and nervous system. Usually, providers recommend lindane shampoo only when other treatments have failed.

Can I use other at-home treatments for pubic lice?

Special lice shampoos or creams are the only treatments that will work. They destroy pubic lice. Shaving or taking hot baths won’t destroy the lice. You can use a hydrocortisone cream to stop the itching, but it won’t treat the lice.

How do I treat lice in my eyelashes?

You need special treatment for lice in your eyelashes. Contact your healthcare provider to find out the best way to treat the problem.

Can I use pubic lice treatment if I’m pregnant or breastfeeding?

If you’re pregnant or breastfeeding, talk to your healthcare provider before using any lice treatment.

Should my sex partner(s) get treated?

Get in touch with your sexual partner(s) from the previous month. They may have pubic lice, too, and will need treatment.

Prevention

How can I prevent genital crabs?

The only guaranteed way to prevent pubic lice is to avoid any close physical contact with people. Still, you can take reasonable steps to lower your risk for crabs and prevent them from coming back:

Do:

  • Limit your sex partners. And try to avoid sex with people who have multiple sex partners.
  • Make sure your partner(s) get treated if you had pubic lice.
  • Wash and dry clothing, bedding and towels.
  • Finish treatment and check that the crabs are gone before resuming sex.

Don’t:

  • Have sex or close physical contact with someone who has crabs.
  • Share clothing, bedding or towels with a person who has crabs.
  • Use insecticide sprays. They don’t control crabs and can be harmful.
  • Try on bathing suits when shopping. If you do try them on, wear underwear.

Can I use pubic lice shampoo preventively?

Perhaps you found out that a sexual partner from the past month got pubic lice. It’s fine to use one of the lice shampoos or creams to be safe.

Will frequent showers prevent pubic lice?

Getting pubic lice has nothing to do with your hygiene. You get pubic lice by having close physical contact with a person who has them.

Outlook / Prognosis

Are pubic lice dangerous?

No, pubic lice won’t cause serious health concerns. Usually, the main problems that the lice cause are itching and discomfort. You may get a bacterial infection if you end up scratching your skin a lot.

Can I get pubic lice more than once?

Yes, you can get crabs again. Take steps to prevent pubic lice, so you don’t get them again.

Living With

When can I resume sex?

Pause your sex life until both you and your partner(s) have finished treatment. Check that the lice have not returned.

What else should I ask my healthcare provider?

If you have pubic lice, ask your provider:

  • What pubic lice treatment do you recommend?
  • How many times should I do the treatment?
  • When can I resume having sex?
  • Should I tell my sexual partner(s) that I have pubic lice?
  • How can I prevent the lice from coming back?
  • Are there any long-term complications from crabs?

A note from Cleveland Clinic

If you have pubic lice, or genital crabs, don’t feel alarmed. While crabs can be annoying and cause discomfort, it’s easy to treat them. Pubic lice won’t cause long-term health problems, either. If you’re not sure you have crabs, talk to your healthcare provider. Pubic lice treatment usually involves special creams or shampoos to destroy the lice. After treatment, make sure to comb any nits (eggs) out of your hair. Wash all clothes, bedding and towels to destroy any lice living there. And suggest to recent sexual partner(s) that they get treated as well.

Last reviewed by a Cleveland Clinic medical professional on 12/17/2020.

References

  • American Sexual Health Association. Pubic Lice: Fast Facts. (https://www.ashasexualhealth.org/crabs/) Accessed 12/21/2020.
  • Centers for Disease Control and Prevention. About Pubic “Crab” Lice. (https://www.cdc.gov/parasites/lice/pubic/gen_info/faqs.html) Accessed 12/21/2020.
  • Planned Parenthood Federation of America. Pubic Lice (Crabs). (https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/pubic-lice) Accessed 12/21/2020.

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