Everything You Need to Know About Pubic Lice (Crabs)
Medically reviewed and edited by 
Highlights
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Pubic lice are small parasites that live and lay eggs in the hair surrounding the genitals. They can also spread to other areas with coarse body hair like the armpits, eyebrows, and beard.
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Symptoms of a pubic lice infestation include intense itching, insect bites, and red splotches around the genital area.
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It’s essential to get treatment for pubic lice and this may include using over-the-counter (OTC) or prescription medications and manual removal.
Pubic lice — also known as crabs — is a relatively common health concern in the United States that affects millions of Americans every year.
Although it may be uncomfortable to deal with, it’s important to know what to do and when to see a doctor if you suspect that you have an adult pubic lice infestation.
While these lice may not be detrimental to your health, prolonged infestations can cause skin damage and lead to emotional distress that may impact your quality of life.
In this article, we’ll take a closer look at what exactly pubic lice are, how you get them, and methods of treating it.
What are Pubic Lice?
Pubic lice are tiny insects that infest the hair in the genital area.
Although these lice are primarily found in the pubic area, they can also infest other parts of the body with coarse hair, like the armpits, chest, and eyebrows.
Key Point: Are Pubic Lice Sexually Transmitted Diseases (STDs)?
Pubic lice are often categorized as sexually transmitted infections (STIs) because the most common way to get pubic lice is through sexual contact, similar to STDs.
How is Pubic Lice Spread?
Crabs are primarily transmitted through close physical contact. There are a few ways that this could happen, including:
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Sexual activity: Engaging in sexual activities that involve skin-to-skin contact — such as vaginal, anal, and oral sex — is the most common way to get pubic lice.
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Sharing personal items: You can become infested with pubic lice by sharing items like clothing, underwear, towels, and bedding. It’s also possible for pubic lice to spread when sleeping in the same bed as an infested person.
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Close personal contact: Other than sexual activities, pubic lice can also spread through close contact, such as hugging, dancing, or skin-to-skin activities.
While a pubic lice infestation is easily spread, it’s important to note that these parasites can’t jump or fly, so direct contact is required for transmission.
The best way to prevent an infestation is to practice safe sexual behaviors and have open communication with your partners.
It might also be worth avoiding close contact and sharing personal items with partners until the pubic lice infestation has cleared up.
Key Point: What Do Pubic Lice Look Like?
Although lice can be hard to spot, you may be able to see them by using a magnifying glass or looking closely at your pubic hair. The lice are typically tan or gray in color.
What are the Symptoms of Pubic Lice Infestations?
Symptoms of a pubic lice infestation can vary from person to person. Some of the most common signs of crabs tend to include:
- Intense itching in the genital area
- Blue-gray or blood spots on the skin around the genital area
- Irritated skin that may be red or blotchy from the lice bites
- Fever and other flu-like symptoms
- Small white dots on the pubic hair that are difficult to remove
- The presence of tiny bugs in your pubic hair
It may take up to five days for symptoms to appear after you’ve been infested. If you suspect that you have a pubic lice infestation, see your doctor as soon as possible.
How is a Pubic Lice Infestation Diagnosed?
A pubic lice infestation should be diagnosed by a sexual health provider. They will typically use a magnifying glass to inspect the genital area to spot the lice and physically remove them.
Your doctor will likely inspect the parasite to determine if it’s pubic lice and recommend testing for STIs if it is.
Can You Prevent or Get Rid of Pubic Lice?
Pubic lice are one of the easiest STIs to get rid of. There are various remedies you can use to treat an infestation. We have listed some popular options below:
Over-the-counter (OTC) remedies
An OTC pubic lice treatment is typically formulated to kill the parasites.
The products contain insecticides like permethrin and pyrethrin that inhibit the growth of the parasites while destroying any remaining lice eggs.
When using these products, it’s important to follow the instructions carefully to avoid irritating the genital area even more.
Key Point: Will Pubic Lice Go Away if You Have Good Hygiene?
Improving your hygiene or using regular soap and water to eliminate pubic lice won’t be an effective treatment.
These actions typically don’t play a role in becoming infected, and items like normal soap don’t contain ingredients strong enough to kill lice.
Prescription medications
If OTC products aren’t effective, your healthcare provider may recommend stronger prescription medications to treat your infestation.
These medications may include topical creams or lotions containing active ingredients that are intended to kill the lice and destroy their eggs.
Manual removal
Along with using medication, manual removal is an essential part of treating a pubic lice infestation.
This can usually be done by using a fine-toothed comb to work through the pubic hair and remove the lice.
It may be necessary to repeat this process a couple of times over the course of a few weeks to ensure all the pubic lice nits (eggs) are removed.
Key Point: Can a Pubic Lice Infestation Go Away Without Treatment?
While it’s possible for a pubic lice infestation to clear on its own, it’s not recommended to rely on this outcome.
Without proper treatment, pubic lice infestations can persist and worsen over time. Not only will this cause continuous symptoms, but it significantly increases the risk of spreading it to your sexual partners.
A prolonged infestation can also cause other complications, such as skin damage and an increased chance of becoming infected with other STDs.
When Should You See a Doctor about Pubic Lice?
It’s recommended to see a doctor or sexual health provider as soon as you suspect that you have a pubic lice infestation.
If you’re unsure whether your symptoms are caused by pubic lice or something else, you should also make an appointment with your doctor.
Additionally, you should see your healthcare provider if you:
- Don’t experience results using OTC products
- Suspect that you have other STDs
- Have complications or infections that cause intense skin irritation and open sores
- Have a recurring pubic lice infestation
Your doctor will be able to help you with a professional diagnosis and tailored treatment recommendations to help you overcome an infestation.
They can also address any concerns or questions you may have about pubic lice and other STIs.
Where Can You Learn More About Pubic Lice and Similar Conditions?
If you suspect that you have crabs or you’re concerned about any of your symptoms, you can speak to a board-certified physician or nurse from the comfort of your home.
Our team of experts can also recommend appropriate STI treatments and answer any questions you have.
Head over to LifeMD to make a telehealth appointment today.
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