Pubic Lice (Crabs): Symptoms & Treatment

If you’re feeling intense itching around your pubic area that will just not go away, you might be harboring pubic lice, also known as crabs. If you have pubic lice it doesn’t mean you have poor hygiene–it just means you’ve shared bedding, towels, or had close personal contact with someone who has them. According to Planned Parenthood, about 3 million people in the U.S. get pubic lice every year.

Pubic lice are tiny insects that resemble miniature ocean crabs; they live in pubic hair and skin and subsist on your blood. While that might sound scary and feel extremely uncomfortable, pubic lice are not dangerous, and are fairly easy to treat.

The genital area is the most common place to find pubic lice (hence their name), but they can also live in other coarse hairs on the body, like the eyebrows, eyelashes, beards, mustaches, and chest and armpit hair. However, crabs are a different type of insect from head and body lice, and their treatment differs as well.

You can treat pubic lice with over-the-counter or prescribed rinses of the affected area. Treatment should also include a thorough, hot washing of all bedding and clothes.

What are Pubic Lice (Crabs)?

Pubic lice, or crabs, are small parasites that attach to your pubic hair and skin. The itchiness and irritation you feel is caused by your body reacting to their bites.

The most common way to get pubic lice is through sex or close contact that involves genital areas touching. But you can also get them by sharing bedding, clothes, and towels with someone who has a public lice infection.

It’s also possible, though less common, to get them from elsewhere on someone’s body, like eyelashes, eyebrows, chest hair, armpits, beards, and mustaches. Pubic lice do not live in the hair on your head.

Pubic Lice Symptoms

The most common symptom of pubic lice is itching near your genitals. Pubic lice are big enough to be visible to the naked eye – they measure about 1/16 inch (or 1.6 millimeters), so you may also see them or their eggs in your pubic skin and hair. Pubic lice symptoms usually start about five days after exposure.

Pubic lice symptoms include:

• Intense itching in your genital area
• Small tan or whitish-gray bugs that look like tiny crabs in your pubic area
• Very small (smaller than the crabs) oval, yellow, or white public lice eggs (called nits) on the bottom part of your pubic hairs. Nits can appear singly but more often they appear in clumps.
• Skin around your genital area may turn darker like a bruise. This is a reaction to pubic lice bites.

Pubic Lice Diagnosis

Diagnosis usually consists of a visual examination of your pubic area. Your doctor will look for nits and live moving pubic lice. If there aren’t many, or if they are very small, your doctor may use a magnifying glass or microscope to search for them.

Pubic Lice Treatment

Pubic lice are easy to treat, and the treatments are fairly easy to use. Some are even over-the-counter and don’t require a prescription. Treatment involves washing with a gel, shampoo, liquid, or foam, and then picking or combing off the dead crabs and nits. If you still see crabs or nits after about ten days, you may need to repeat the treatment or see your doctor for a prescription for a stronger medication. Also, if you have crabs in your eyebrows or eyelashes, you’ll need a special prescription treatment, as the standard methods aren’t safe for use near eyes. Finally, pregnant or breastfeeding women should consult a doctor before using any treatment.

In addition to treating your body with medication, you should wash all of your bedding, clothing, and towels on the hottest setting, and dry them on the hot cycle. If there are fabrics that can’t be washed, you can dry clean them or seal them in a plastic bag for at least two weeks, which is how long it will take for the crabs and nits to die. It’s also a good idea to vacuum rugs and furniture, but an exterminator or fumigator is not usually necessary.

Anyone you’ve had intimate contact with or have shared clothes, towels, or bedding with should treat themselves and wash their linens as well.

It’s a good idea to wait to have sex until you and your partner(s) have finished treatment so you don’t pass an infection back and forth. It’s also smart not to share clothes or bedding until you’ve finished all treatments.

Pubic Lice Prevention

The only guaranteed way to prevent pubic lice infestation is to avoid having sexual contact or sharing bedding or clothing with anyone who has an infestation. Unfortunately, while condoms are great for protecting against most STDs, they do not protect against public lice since the crabs live outside of the areas that condoms cover.

If you know someone has crabs, avoid having sexual contact (in which genital areas touch), sharing clothes, towels, and beds with them until they finish treatment and wash all of their clothes, bedding, towels, etc.

If you find out that someone you’ve had sex with in the past month has crabs, it can be a good preventative measure to treat yourself and wash your linens just in case.

When to See a Doctor

If your pubic area feels very itchy, it’s a good idea to see your doctor for examination and diagnosis. You should also visit your doctor if:

• You treated yourself with over-the-counter products but still think you have a public lice infection.
• You think you have pubic lice and you’re pregnant or breastfeeding.
• You’ve been scratching so much that you’ve cut or infected your pubic skin.
• You are so itchy or uncomfortable it interferes with your ability to participate normally in your life. There are topical creams for itching you can use while the treatment takes effect.

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