Pubic Lice

1 What is Pubic Lice?

Pubic lice, also called crabs, are small but visible insects that inhabit genital area. These lice differ from those found in head and body.

These lice have bodies similar to that of tiny crabs, hence the name crabs. They are usually transmitted through sexual contact. However, they can also spread by sharing contaminated clothing, bed linens or towels.

If you observe pubic lice in children’s eyebrows or eyelashes, you may suspect cases of sexual abuse. Pubic lice survives on your blood and sucks the blood out by biting your skin.

These bites can result in severe itching. Various nonprescription creams and lotions to kill the parasites and their eggs are available in the market.

2 Symptoms

The most common symptom of having pubic lice is severe itching in your genital area. As the lice can infest other parts like legs, chest, armpits, beard, eyelashes or eyebrows, it can also cause irritation and itching on these affected areas too.

When to see a doctor?

Consult your doctor if:

  • Nonprescription medications have become ineffective
  • You're pregnant
  • Severe scratching causes infections

3 Causes

Pubic lice are usually caused through sexual contact. However, they can also spread through contaminated clothing, bed linens or towels.

4 Making a Diagnosis

The diagnosis of public lice can be confirmed by visual inspection of pubic area. The lice can be seen moving, if any or lice eggs (nits) may be seen.

Dead nits may cling to the genital areas even after successful treatment. Consult your doctor if pubic lice persist even after using home or nonprescription remedies.

How to prepare yourself for the visit?

Getting prepared for the visit can optimize the therapy and help make the visit more fruitful. List out all the symptoms. Write down your key medical information.  Write down the names of all your medications, vitamins or supplements.

Make a list of the questions to ask your doctor like:

  • What could be possible cause of my symptoms?
  • What are the tests that I need?
  • What are the treatment options and their side effects?
  • How long will these symptoms last?

What your doctor wants to know?

A clear talk with your doctor can optimize the therapy and improve the outcomes. Prepare yourself to answer some essential questions from your doctor. Your doctor might ask you typical questions like:

  • Have you had sexual contact with someone known to have pubic lice?
  • Have you been diagnosed with other sexually transmitted infections?
  • When do you think you acquired pubic lice and how?
  • What are your symptoms?
  • Have you transmitted the infestation to others?
  • What are the treatments you tried?

5 Treatment

You can start the treatment of pubic lice through the use of over-the-counter lotions or shampoos. If they do not work, you may need to use stronger prescription medications, such as:

  • Malathion: Available as lotion, it can be applied to the affected area. After 8-12 hours it can be washed off.
  • Ivermectin: A single dose of two pills can be useful in treating pubic lice. If this dose is ineffective, you may repeat the dose in 10 days.
  • Lindane: Its use is restricted to severe unresponsive cases because of its toxicity. A single application followed by washing after 4 minutes is effective in most cases. DO NOT use lindane:

       o During pregnancy or breast-feeding
       o In infants or young children, elderly people, or anyone weighing less than 110 pounds

  • Eyelash and eyebrow treatments: To treat the pubic lice in eyelashes and eyebrows, you can apply petroleum jelly with a cotton swab at night and wash it off in the morning. Repeated applications for several weeks may be required. Common side effect is eye irritation.

6 Prevention

To prevent pubic lice infestation, avoid having sexual contact or sharing bedding or clothing with anyone who has an infestation. If you are being treated for pubic lice, all sexual partners must also be treated.

7 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with pubic lice.

Maintaining personal hygiene and avoiding contact with infested person or items are the keys to managing this problem.

Here are some tips that might help you: 

  • Chose lotions and shampoos that are specifically designed to kill lice. Use the products only as directed.
  • Thoroughly wash contaminated items such as bedding, clothing and towels using hot water (at least 540 C) and soap, two days prior to treatment. Dry them at high temperature for at least 20 minutes.
  • You may also dry-clean certain items that cannot be washed.

8 Risks and Complications

There are several risks and complications associated with pubic lice.


  • Having other sexually transmitted infections can raise your risk of getting pubic lice.


  • Discolored skin: Continuous blood sucking can cause pale blue spots on the affected area.
  • Secondary infections: Severe scratching can cause wound which might become infected if not treated properly.
  • Eye irritations: If pubic lice reach eyelashes, they might cause irritations and pink eye (conjunctivitis). It is more common in children.