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Pubic Lice

Symptoms, Causes, Treatments, Questions & Related Topics

Key Points

  • Pubic lice, also known as "crabs," are small insects that infest the genital area but can also be found in other areas of the body. They are transmitted through close contact, including sexual contact, sharing clothing, bedding, or towels.
  • Pubic lice infestations are common, with around 3 million cases reported annually in the United States. While they are considered an infestation and not a disease, the itching caused by pubic lice can lead to skin irritation and potential secondary infections.
  • Pubic lice are different from head lice and body lice. They have a distinct appearance and prefer the genital area. Treatment options include over-the-counter shampoos and creams containing permethrin, but stronger prescription medications may be necessary in some cases. It is important to follow treatment instructions and take preventive measures, such as washing and drying infested items, to avoid reinfestation.

What are pubic lice?

Pubic lice are small insects that infest the genital area of an infected person. Pubic lice are often called “crabs” because of their crab-like appearance. According to the Mayo Clinic, it is rare but possible to get pubic lice in other areas of the body, such as:

  • Legs
  • Chest
  • Armpits
  • Bear or mustache
  • Eyelashes or eyebrows

Pubic lice are caused by having close contact with an infected person. This includes:

  • Sexual contact
  • Sharing clothing
  • Sharing bedding
  • Sharing towels

How common are pubic lice?

According to the Cleveland Clinic, pubic lice are very common. Around 3 million people are diagnosed with pubic lice each year in the United States.

Are pubic lice a disease?

Having pubic lice is considered an infestation. According to the CDC, lice are not known to transmit any disease, however, the itching that comes along with a lice infestation can cause scratches and sores. These scratches and sores can become infected by bacteria from the skin or fingernails.

Is having public lice considered an STI?

Pubic lice is not an infection or disease. However, it is spread primarily by sexual contact, therefore it is often associated with STIs. It is important to note that it can also be passed from one person to another through non-sexual contact.

Are pubic lice the same as head lice?

According to the Mayo Clinic and CDC, pubic lice are different than head lice and body lice. Pubic lice have a specific crab-like appearance and prefer to stay in the genital area.

How do you get pubic lice?

Like other types of lice, pubic lice spread by having close contact with someone who is infected.

How do pubic lice spread?

Pubic lice are mainly spread by sexual contact, however, it is possible to contract pubic lice from other close contact situations, such as:

  • Sharing clothing
  • Sharing towels
  • Sleeping in the same bed

Who is at risk for pubic lice?

Anyone who is sexually active can get pubic lice. Younger people are more often affected, according to the CDC. Cedars Sinai notes that pubic lice cases are decreasing, likely because genital hair removal is a popular trend.

According to the Mayo Clinic, people who have other STIs are most likely to have or get pubic lice.

Can I get pubic lice from a pet?

According to the CDC, pubic lice is not spread by contact with animals.

Can children get pubic lice?

It is possible for children to get pubic lice. According to the CDC, it is more common for children to get pubic lice in their eyelashes and eyebrows. Also according to the CDC, pubic lice in children can be a sign of sexual abuse.

What are the signs and symptoms of pubic lice?

The first and most common symptom of pubic lice is itching in the genital area, especially in areas that have hair. The full list of symptoms, according to the CDC includes:

  • Severe itching in the hairy areas of the pubic area
  • Irritated skin that may be bloody or red from lice bites and itching
  • Specks of black dots in the pubic area or in your underwear (this is lice droppings)
  • Small white dots in the pubic hair that are hard to remove (these are lice eggs)
  • Pale bluish spots on your thighs, buttocks, and lower abdomen
  • Fever and fatigue

How do you know if you have pubic lice?

It may be possible to see pubic lice with the naked eye, however, this may be difficult to do by yourself. A healthcare provider can diagnose pubic lice by visual exam.

Why do crabs itch?

Pubic lice bite to feed on blood. These bites typically cause itching similar to a mosquito bite. The itching may be so intense that more skin irritation occurs.

Testing for pubic lice

There is no definitive test for pubic lice. A healthcare provider can diagnose pubic lice with a visual exam.

Treatment for pubic lice

Pubic lice will not go away on their own. There are some over-the-counter treatment options, however, some infestations need a stronger treatment (available by prescription). Most treatments take around two weeks to cure a pubic lice infestation, according to the Cleveland Clinic.

To ensure that you don’t become reinfected, it is important to treat any clothing, towels, or bedding that you use as well. The CDC recommends washing all clothing, towels, and bedding with hot water and a hot dryer cycle. Anything that cannot be machine washed should be sealed in a plastic bag for 2 weeks.

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

“Lice-killing” shampoos containing 1% permethrin, or pyrethrins, and piperonyl butoxide are available over-the-counter at most drug stores. The CDC recommends using these products according to the package directions as the first-line treatment for pubic lice that are in the genital area.

For pubic lice in the eyelashes or eyebrows, a special ointment is available by prescription only.

Are there prescription medications for pubic lice?

If over-the-counter lice treatment does not work, Lindane lotion is a prescription lotion that can be used for the treatment of pubic lice. The CDC notes that this lotion can be toxic and therefore is not used as a first-line treatment.

Alternatively, ivermectin lotion is also FDA-approved for the treatment of pubic lice, if over-the-counter lotions do not work.

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

You may find several “home remedies” for pubic lice on the internet, however, these may cause further irritation, and may prolong the infestation by not fully treating it. It is best to use FDA-approved treatments and consult a healthcare provider if the treatment doesn’t work.

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

Women who are pregnant or breastfeeding should consult a pharmacist or healthcare provider before using over-the-counter medications for pubic lice.

Should my sex partner(s) get treated?

The CDC recommends that you notify all your sexual partners from the previous month when you get diagnosed with pubic lice.

How to prevent crabs

The only way to prevent pubic lice is to avoid direct contact with people who have pubic lice. Here are more steps you can take to lower your risk of being exposed, as outlined by The Cleveland Clinic:

  • Avoid sharing personal items like clothes or towels
  • Avoid trying on underwear or bathing suits before they are washed
  • Limit your sex partners
  • Have open and honest communication with your sex partners about their sexual health
  • Complete treatment and have a thorough recheck to ensure that your pubic lice infection has fully resolved before resuming sex

It is important to note that condoms will not prevent you from getting pubic lice.

Can I use pubic lice shampoo preventively?

The CDC stresses the importance of following package directions when it comes to over-the-counter treatments like lice shampoos and lotions. These products are meant as a treatment, not a prevention strategy.

Will frequent showers prevent pubic lice?

While good hygiene is important for your health, it should not effective in preventing or treating pubic lice, according to the Cleveland Clinic.

It is important to note that getting pubic lice is not related to poor hygiene.

Issues and conditions related to Pubic Lice

Usually, pubic lice do not cause serious health concerns, according to the Cleveland Clinic. However, it is possible to develop a secondary infection if bacteria is introduced to scratches caused by itching or to the bite marks from the lice.

Pubic lice vs. scabies

Pubic lice are parasitic insects that infest the pubic hair region, while scabies are small mites that infect the skin, particularly in the genital area. Pubic lice and scabies can cause similar symptoms. However, they are two different causes.

Frequently asked questions

  • How serious are pubic lice?

    Pubic lice are generally a mild ordeal that is easily treated with over-the-counter treatments. However mild, pubic lice cause intense itching which can lead to skin irritation.

  • How do you get rid of pubic lice?

    The most effective way to get pubic lice is to use an over-the-counter pubic lice treatment (usually in the form of a lotion that is applied and washed off after a certain amount of time), according to the CDC. After treatment, it is important to wash all towels, bedding, and clothing with hot water and a hot dryer setting. Any of your recent sexual partners should also get treated, according to the CDC.

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

    Pubic lice do not live long once off the human body, according to the CDC—therefore it is unlikely that you can get pubic lice from a shared toilet seat.

  • Can you get pubic lice without being sexually active?

    It is possible to get pubic lice if you share clothing or towels with someone who has an infestation. It is also possible to get pubic lice if you sleep in the same bed as someone with an infestation.

  • How long does it take to get rid of crabs?

    With over-the-counter treatment, you should get rid of pubic lice within two weeks. You may need a second treatment 7-10 days after the first treatment, according to the Mayo Clinic.


Solv has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

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