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Pubic lice

Pubic lice are very small, crab-like parasitic insects which live on the pubic hair. Pubic lice are not necessarily sexually transmitted, but are passed on through close body contact.

Here are some key facts:

  • As well as pubic hair, pubic lice may also be found on underarm, leg, back or facial hair 
  • They are sometimes referred to as ‘crabs’ because they look like crabs
  • Pubic lice may be passed on by sharing towels and bed linen
  • Symptoms can take a few weeks to appear
  • Symptoms include itching, irritation and inflammation
  • You may be able to see black powder (droppings), brown eggs or the yellow-grey or red lice
  • Diagnosis involves a health professional examining the area with a magnifying glass
  • Treatment involves using insecticide lotion or shampoo

You can read about pubic lice in more detail below.

Signs and symptoms of pubic lice

Pubic lice can take a few weeks to appear so you may not notice them immediately. Some people may not have any symptoms or notice them.

When they do appear, they are tiny (approximately 2mm) and difficult to see. 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.

You may notice other signs like:

  • Itching in the affected areas (caused by a reaction to the louse saliva)
  • Black powder in your underwear (this is the droppings from the lice)
  • Brown eggs on pubic or other body hair
  • 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)

Eyelashes and eyebrows can also be affected but this is less common.

The causes and how it is passed on

Having pubic lice is in no way a sign of poor hygiene. They are spread by having close body contact with someone that has them and will crawl from hair to hair. 

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. Pubic lice cannot transmit HIV or other STIs.

Pubic lice are different to head lice and pubic lice do not live in the hair on your head. They prefer coarser but more widely spaced hair.

Condoms will not protect you from pubic lice.

Testing for pubic lice

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.

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

Treatment of pubic lice

Treatment can be done at home using special types of insecticide lotions, creams or shampoo:

  • You can get these on prescription or over the counter at a pharmacy
  • You may have to apply these solutions to the affected area or your whole body 
  • Often you will need to apply, leave for a set time and then rinse off
  • This process usually needs to be repeated after three to seven days to ensure the eggs are killed off as well
  • You can treat pubic lice while you are pregnant or breast feeding but do let your doctor, nurse or pharmacist know – they will advise which treatments are safe to use
  • Sometimes pubic lice can develop a resistance to the treatment so you may need to return to your doctor or pharmacist to get another type
  • The nurse, doctor or pharmacist will be able to advise on use of 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
  • You may find there are empty eggshells stuck to the hairs after treatment but this doesn’t necessarily mean you still have pubic lice
  • You will not need to shave off your pubic hair as part of this process 
  • Shaving won’t necessarily protect you from further infestations because pubic lice only need a tiny amount of hair to lay eggs on

You will need to ensure that anyone you have had close body contact with is treated too – as well as anyone you live with.

It is also recommended that you wash your sheets and towels at 50 degrees or higher to kill off the lice and their eggs.

Avoid having further close body contact until you and your partner have finished treatment. This includes any sexual activity. It is advised that you do not have any sexual intercourse, including vaginal, anal or oral sex until you and your partner have finished treatment and any follow up treatment. This is to prevent you being re-infected or passing the infection on to someone else.

If they are left untreated, the lice may spread to other parts of the body. The side effects can also cause other issues such as skin irritation and infections. Pubic lice will not go away without treatment and are likely to be passed to someone else.

Page last reviewed: July 2015
Next review due: July 2017