Pubic lice (‘crabs’)

Public lice can be difficult to spot because they are tiny (approximately 2mm). If you can see them, they are six-legged, with two larger legs like claws (which is why they are sometimes called ‘crabs’. They are often yellow-grey or red in colour and they attach their eggs to the base of the hairs. The eggs are pale brown in colour and the empty egg sacs are white.

Pubic lice can take a few weeks to appear so you may not notice them immediately or have any symptoms. They are usually found on pubic hair but sometimes they can be on chest, armpit, face or eyelash hair.

Aside from if you are able to see them, other pubic lice symptoms include:

• Itching in the affected areas (caused by a reaction to the louse saliva and is often worse at night)
• Brown powder in your underwear (this is the droppings from the lice)
• White or yellow dots on hair (eggs)
• Irritation and inflammation in the affected area (sometimes caused by scratching)
• Sky-blue spots or very tiny specks of blood on the skin (caused by lice bites)

Having pubic lice is not a sign of poor hygiene. They can be passed on through any close body contact including vaginal, anal or oral sex and they may be passed on by sharing towels and bed linen (though this is much less common as lice can only survive for around 24-48 hours if not in contact with the human body).

They cannot jump like fleas or fly and they survive on human blood.

Condoms will not protect you from pubic lice but will protect against STIs.

If you suspect you have pubic lice, you need to visit one of the Brook services, a GUM or sexual health clinic or your local GP surgery. Find your nearest service

There is no test for pubic lice but it is easy for a doctor or nurse to diagnose by examining the areas with a magnifying glass and comb. They will be looking for the lice and their eggs.

Pubic lice will not go away without treatment and are likely to be passed to someone else. Treatment can be done at home using special types of lotions, creams or shampoos which kill the lice. You usually have to apply the shampoo or cream all over your body and may have to repeat this process again to make sure they are all gone.

Make sure to…

• Apply the solutions to the affected area or your whole body
• Return to your doctor if the treatment doesn’t work – sometimes pubic lice can develop a resistance to the treatment
• Check for lice a week after treatment or return to your local Brook service, GUM or sexual health clinic or GP to get them to check for you
• Ensure that anyone you have had close body contact with is treated too even if they don’t have symptoms
• Wash your sheets, towels and bedding at 50 degrees or higher to kill off the lice and their eggs

Avoid…

• Having any sexual intercourse, including vaginal, anal or oral sex until you and your partner have finished treatment and any follow up treatment.
• Shaving; it won’t do any harm but it won’t necessarily protect you from further infestations because pubic lice only need a tiny amount of hair to lay eggs on.
• Sharing clothes, bedding, or razors until you have finished treatment

You can treat pubic lice while you are pregnant or breastfeeding but do let your doctor, nurse or pharmacist know – they will advise which treatments are safe to use.