Healthy lives for young people
STIs

Pubic lice (‘crabs’)

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.

Signs and symptoms of pubic lice

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

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.

Other signs and symptoms include:

  • 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)

As well as pubic hair, they may also be found on underarm, leg, back or facial hair. 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 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 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. Find your nearest using our find a service tool.

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

Treatment of pubic lice

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 insecticide lotions, creams or shampoo which you can get these on prescription or over the counter at a pharmacy.

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. You may find there are empty eggshells stuck to the hairs after treatment but this doesn’t necessarily mean you still have pubic lice.

DO

  • Apply the solutions to the affected area or your whole body
  • Repeat the process again after three to seven days to ensure the eggs are killed off as well
  • 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 – as well as anyone you live with
  • Wash your sheets and towels at 50 degrees or higher to kill off the lice and their eggs

DON’T

  • Don’t have further close body contact until you and your partner have finished treatment
  • Don’t have any sexual intercourse, including vaginal, anal or oral sex until you and your partner have finished treatment and any follow up treatment
  • Don’t have to shave – shaving won’t necessarily protect you from further infestations because pubic lice only need a tiny amount of hair to lay eggs on

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.

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