Pubic Lice

If you have pubic lice, also called crabs, you may have a bad itch in your genital area. Pubic lice can spread to other areas of the body with thick hair, including the:

• Legs.
• Chest.
• Armpits.
• Beard or mustache.
• Eyelashes or eyebrows, more often in children.

For pubic lice, see your healthcare professional to find out if you have other sexually transmitted infections. Children with pubic lice need to see a healthcare professional to check for signs of sexual abuse.

Seek medical advice about pubic lice treatment if:

• You’re not sure if you have crabs.
• Products you get without a prescription don’t kill the lice.
• You’re pregnant.
• You have infected skin sores from scratching.

Pubic lice spread from the hair of one person to the hair of another. Pubic lice most often spread during sex. You also may get pubic lice from sheets, blankets, towels or clothes that have lice in them.

Having sex with a person who has pubic lice raises the risk of getting them. Public lice on children may be a sign of sexual abuse.

Having pubic lice sometimes leads to complications such as:

• Discolored skin. You may have pale blue spots where pubic lice have been feeding. These may be harder to see on Black or brown skin.
• Infections from scratching. Scratching itchy lice bites a lot can cause the sores to get infected.
• Eye irritation. Children who have pubic lice on their eyelashes may get a type of pink eye, also called conjunctivitis.

To keep from getting pubic lice, don’t have sex or share bedding or clothes with anyone who has them.

You or your healthcare professional most often can tell there are pubic lice by looking at your genital area. Seeing moving lice confirms the diagnosis.

Lice eggs, also called nits, may mean you have lice. But nits can continue to cling to hairs even when they die after treatment.

Treatment for pubic lice often starts with products that have permethrin or pyrethrin. These are products you can get without a prescription. You put them on the genital area. Follow the package directions closely and repeat the treatments as directed.

If you have only a few live lice and nits after treatment, you may be able to remove them using a nit comb or your fingernails. If you need more treatment, a healthcare professional may prescribe stronger treatments. These might include:

• Malathion. You put this prescription lotion on the area that has lice. Wash it off after 8 to 12 hours.
• Ivermectin (Stromectol). You take this medicine as a single dose of two pills. If that doesn’t kill all the lice, you can take another dose in 7 to 10 days. Do not take this medicine if you are pregnant or breastfeeding.
• Eyelash and eyebrow treatments. To treat pubic lice in eyelashes and eyebrows, use a cotton swab to put petroleum jelly on them at night. Wash it off in the morning.

You may need to repeat this treatment for a few weeks. Take care not to get petroleum jelly in the eyes. Check and treat all hairy areas of the body. Lice can move away from treated areas to other hairy parts of the body. Sexual partners of anyone who’s treated for public lice also need treatment.

To get rid of pubic lice, try these steps:

• Use lotions and shampoos. Choose from among lotions and shampoos made to kill lice (Nix, others) that you can get without a prescription. Use the product as the package instructs. You may need to repeat treatment in 7 to 10 days.
• Wash items that may have lice. Wash bedding, clothing and towels used in the 2 to 3 days before treatment. Use hot, soapy water that’s at least 130 degrees Fahrenheit (54 degrees Celsius). Dry the items at the hottest setting for at least 20 minutes.
• Dry-clean or seal items you can’t wash. If you can’t wash an item, have it dry-cleaned. Or put it in an airtight bag for two weeks.