Sexual Health Advice - Patient Information Leaflets

Pubic Lice

What are pubic lice?

Pubic lice are tiny insects about 1 – 2 mm long and are grey or brown in colour. They have a crab like appearance - hence often called ‘crabs'. They lay eggs which are known as ‘nits' which appear as brown dots fixed to hair.

Pubic lice commonly affect pubic hair. However, they may also affect hair around the anus, beards and moustaches, underarm hair, chest hair and body hair including eyelashes and eyebrows. As scalp hair is a different type of hair a different kind of louse called the head louse usually infests scalp hair.

How do you get pubic lice?

Pubic lice are easily passed from one person to another by close body contact. For example, you may ‘catch' pubic lice by hugging someone with an infected beard or moustache or during sex.

Pubic lice are not passed on from bed linen, clothing or toilet seats as they die if not in contact with a human body.

What are the symptoms of pubic lice?

Some people have no symptoms and not realise that they have pubic lice.

It can take several weeks to getting symptoms and signs before realising it. The signs and symptoms are the same for men and women:

a) Itching in the affected areas.
b) Faint blue spots on the nearby skin
c) Skin irritation and scratching may cause redness or a rash in affected areas
d) Black powdery marks from the lice on your underwear
e) Brown eggs on pubic or other body hair
f) Develop eye inflammation if your eyelashes or eyebrows are affected.

What is the treatment for pubic lice?

Over the counter medicines that kill pubic lice contain either malathion in 0.5% aqueous liquid, phenothrin 0.5% aqueous liquid or permethrin 5% dermal cream. They are easy to apply and are successful treatments if used properly i.e.:

An average adult needs about 30 – 60g of cream or 100 ml of lotion to treat the whole body.

The whole body below the neck should be treated as the lice can spread taking particular attention to beards and moustaches, but not other areas of the head, eyes or mouth.

It is not necessary to shave the affected areas. The lotion or cream will treat the lice.

Using a water based lotion is best as alcohol based lotions may sting.

It is recommended to use the lotions or creams for up to 12 – 24 hours and re-applying after washing.

Itching associated with treatment often takes a few days to settle. An antihistamine medicine may help.

Re-application of the same treatment is recommended after 7 days treatment. The second application ensures that any lice that hatch from eggs that survived the first application will be killed before they lay further eggs. During this treatment time you should avoid sex or close body contact with partner, otherwise there is a risk being re-infected.

How is pubic lice diagnosed?

Simply examining you or using a magnifying glass, to look for lice and eggs, can give you the diagnosis.

It may be advisable to be tested for other sexually transmitted infections if sexual contact was the likeliest cause of getting pubic lice.

Do family and friends need treatment for pubic lice?

Ideally recent close contacts and sexual partners should be examined for lice and treated as you can have pubic lice without symptoms.

How will I know how long I have had pubic lice?

It can be impossible to know. It is possible that your partner may have pubic lice and not know. You might never know whether you got it from your current or a previous sexual partner. This can often be difficult to handle. Do not be afraid to talk to Lambda Clinic staff about how you feel.

Pubic Lice PDF file pdf document or Text-only Version

The Lambda Clinic, 22 Somerset Road, Edgbaston, Birmingham, B15 2QQ, Tel: 0121 452 2815