Pubic Lice (Crabs)
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Pubic Lice (Crabs)

Reviewed by: Robyn R. Miller, 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, pubic lice is 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 itchiness and redness.

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. 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

These people need to get checked for pubic lice and treated, if necessary.

How Are Pubic Lice Treated?

Pubic lice are treated with medicine. The medicine kills the lice. The medicine may be a cream, lotion, or shampoo. Some are available at drugstores without a prescription. 

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 and bed sheets used by the person with pubic lice must be:

  • washed in hot water and dried in a hot drier or dry cleaned
    or
  • 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.

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

What Else Should I Know?

If you are diagnosed with pubic lice, it is important to go to the doctor and get checked for other STDs (sexually transmitted diseases).

The best way to completely prevent STDs is to not have sex (vaginal, oral, anal). If you do decide to have sex, use a latex condom every time.

Reviewed by: Robyn R. Miller, MD
Date reviewed: December 2018