Pubic Lice (Crabs)

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Pubic lice are tiny parasitic insects that live on coarse human body hair, such as pubic hair.

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Pubic Lice (Crabs)

What are Pubic Lice (Crabs)?

Pubic lice are tiny parasitic insects that live on coarse human body hair, such as pubic hair.

Pubic lice are sometimes known as crabs because they have two large front legs that look like the claws of a crab.

As well as being found in pubic hair, the lice are also sometimes found in:

  • underarm and leg hair
  • hair on the chest, abdomen and back
  • facial hair, such as beards and moustaches
  • eyelashes and eyebrows (very occasionally)

Unlike head lice, pubic lice don’t live in scalp hair.

How could I get Pubic Lice?

Pubic lice are spread through close bodily contact, most commonly sexual contact.  Pubic lice aren’t related to poor personal hygiene. They’re usually spread through close bodily contact with an infected person.  The lice crawl from hair to hair, but can’t fly or jump. They need human blood to survive, so will only leave the body to move from one person to another.  The most common way pubic lice are spread is through sexual contact, including vaginal, anal and oral sex. Using condoms and other methods of barrier contraception doesn’t protect you against pubic lice.  Other types of close bodily contact, such as hugging and kissing, can also spread the lice.  It’s also possible – though less common – for pubic lice to be spread through sharing clothes, towels and bedding.

How can I avoid getting Pubic lice?

Because Pubic Lice are usually spread by direct skin-to-skin intimate contact. Avoid contact with knowninfected persons and textiles or clothing that may have been infested by someone who has an infestation of pubic lice. To avoid spreading the lice, a person with crabs should not have close or intimate contact with anyone else until the infestation has been fully treated.

What are the symptoms of pubic lice?

After getting pubic lice, it can take several weeks before any symptoms appear. Symptoms include:

  • itching in the affected areas
  • inflammation and irritation caused by scratching
  • black powder in your underwear
  • blue spots or small spots of blood on your skin, such as on your thighs or lower abdomen (caused by lice bites)

Itching is the most common symptom of pubic lice and is an allergic reaction to their saliva. The itching is usually worse at night, when the lice are most active.  Adult pubic lice are very small (2mm long) and aren’t easy to see. They’re a yellow-grey or dusky red colour and have six legs.

The lice lay their eggs (nits) in sacs that are stuck firmly to hairs and are a pale brownish colour. When the eggs hatch, the empty egg sacs are white.  Although pubic lice and lice eggs are small and difficult to see, they may be visible in coarse hair anywhere on your body (apart from hair on your head).

How do I get tested for Pubic Lice?

You can get tested for pubic lice at one of our nurse led sexual health clinics.

The nurse will examine the skin of the affected area.

All of our services are free and confidential.

How is it treated?

Pubic lice can be treated at home with insecticide cream, lotion or shampoo. Your sexual health clinic can advise you about which treatment to use and how to use it (or GP or pharmacist). It’s important to follow their advice.

Some treatments only need to be applied to the affected area, but sometimes the whole body must be treated, taking care to avoid the eyes. The treatment usually needs to be repeated after three to seven days.

If the treatment doesn’t work, you may need to use another type. This is because pubic lice can develop resistance to some treatments. Your GP, pharmacist or sexual health clinic will be able to advise you about suitable alternatives.

To prevent re-infestation, anyone you’ve had close bodily contact with, including any sexual partners you’ve had in the past three months, should also be treated, even if they don’t have symptoms.

Certain groups, such as young people under 18 years of age and pregnant or breastfeeding women, may require a specific type of treatment. Ask your GP or pharmacist for further advice about this.

  • Sexual partners should be treated at the same time as the case.
  • Wash bedding, all clothing including night clothes and bath towels used while infestation was present on a hot wash above temperature of 50C.
  • Testing to exclude other sexually transmitted infections (STIs) is advisable as people infested with pubic lice will have another sexually transmitted infection.
  • After treatment has been completed, ensure that all clothing and linens have been thoroughly cleaned to avoid re-infection or spread of the infection to someone else in the home.

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