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Pubic Lice (Crabs)

Medically reviewed by: Amy W. Anzilotti, MD

What Are Pubic Lice (Crabs)?

Pubic lice are tiny insects (about the size of a pinhead). They usually live in hair in the pubic area (the area near the genitals).  They also can live in the eyelashes, eyebrows, beard, armpit, and other body hair.

Pubic lice usually spread through sex. Less often, they spread by touching infested clothing, towels, and bedding.

Pubic lice are also called "crabs" because of the tiny claws they use to cling to hair.

What Are the Signs & Symptoms of Pubic Lice?

Pubic lice usually cause itchiness. This can get worse at night when the lice become active.

Sometimes, lice bites can lead to skin redness and irritation. Lice in the eyelashes or eyebrows can cause eye irritation.

How Do People Get Pubic Lice?

Most people with pubic lice got them through sex or close sexual contact.

Less often, someone can get pubic lice from sharing clothes, sheets, or towels with someone who has pubic lice.

Lice can't jump from person to person. It is very unlikely that someone would get pubic lice from a toilet seat. Lice can't live away from a warm body for long and they do not have feet that could hang on to a toilet seat.

How Are Pubic Lice Diagnosed?

A health care provider usually diagnoses pubic lice by looking at the insect or nits (the small white egg that clings to hair). If needed, the insect can be sent to a lab for identification.

Anyone diagnosed with pubic lice needs to tell:

  • recent sex partners
  • people who have shared bed sheets, clothes, or towels

They should check for pubic lice and get treated, if needed.

How Are Pubic Lice Treated?

Pubic lice are treated with medicine to kill the lice. It may be a cream, lotion, or shampoo. Some are available at drugstores without a prescription. Any nits in the pubic hair need to be removed. Some people use their fingers or a comb to remove them, while others shave their pubic hair. Shaving does not get rid of pubic lice, though. The person also needs to use the medicine.

Most treatments for pubic lice need to be used more than once. So it's very important to follow the directions included with the medicine.

All clothes, towels, and sheets used by the person with pubic lice must be:

  • washed in hot water and dried in a hot drier or dry cleaned
  • put in a sealed plastic bag for 2 weeks

Can Pubic Lice Be Prevented?

Because pubic lice usually spread during sex, not having sex is the best way to avoid them. Condoms do not protect someone from pubic lice because the lice live outside of the area that condoms cover. Shaving pubic hair does not always prevent pubic lice.

Not sharing clothing, bedding, or towels also can help lower the risk of getting pubic lice.

What Else Should I Know?

If your teen is diagnosed with pubic lice, it is important to talk about the risks of sex. Your teen needs reliable information about STDs (also called STIs or sexually transmitted infections) and unwanted pregnancy. Talk about how:

  • STDs mainly spread through sex.
  • The best way to completely prevent an STD is to not have sex (vaginal, oral, anal). If someone decides to have sex, using a latex condom every time can prevent most STDs.
  • Why it's important to use a reliable method of birth control in addition to condoms. Offer to make an appointment for your teen to talk to a health care provider about birth control.

If you don't feel comfortable talking with your kids about STDs and other topics related to sex, make sure they can turn to someone else for accurate information. This could be a doctor or , counselor, school nurse, teacher, or a trusted family member.

Medically reviewed by: Amy W. Anzilotti, MD
Date reviewed: January 2022