Sexual Health Advice - Patient Information Leaflets
Pubic Lice
What are pubic lice?
Pubic lice are tiny insects about 1 – 2 mm long. They are grey or brown in colour. They have a crab like appearance, so are often known as ‘crabs'. They lay eggs which are known as ‘nits'. These appear as brown dots fixed to the hair.
They commonly affect the pubic hair. However, they may also affect hair around the anus, underarm hair, beards, chest, and body hair. Eyelashes and eyebrows are occasionally affected. Scalp hair is a different type of hair, and is not usually affected. A different kind of louse called the head louse usually infests scalp hair.
How do you get pubic lice?
Pubic lice can easily be 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.
They can also be passed from one person to another during sex.
Pubic lice are not passed on from clothing, bed linen, or toilet seats as they soon die if they are away from a human body.
Getting pubic lice has nothing to do with poor hygiene.
What are the symptoms of pubic lice?
b) Black powdery droppings from the lice in your underwear
c) Brown eggs on pubic or other body hair
d) Faint blue spots may appear on the nearby skin
e) Skin irritation and scratching may cause redness or a rash in affected areas
f) You may develop eye inflammation if your eyelashes or eyebrows are affected.
What is the treatment for pubic lice?
You can buy an over the counter lotion or cream that kills the lice. You can also get them on prescription. Commonly used preparations include: malathion 0.5% aqueous liquid, permethrin 5% dermal cream, or phenothrin 0.5% aqueous liquid. They are easy to apply and normally work well if used properly. Follow the instructions on the packet. The following is a general guide giving tips for success.
How is pubic lice diagnosed?
In most cases, a doctor or nurse can tell if you have pubic lice just by looking. They may use a magnifying glass to look for lice and eggs.
Your doctor/nurse may advise that you are tested for other sexually transmitted diseases if sexual contact is the likely cause of pubic lice.
You do not need to shave the affected areas. The lotion or cream will clear the lice.
Some people advise washing bed linen, towels, and clothes (particularly underwear) which has been used since a week before symptoms started. There is no good evidence that this is necessary, but some people prefer to do it.
If your eyelashes or eyebrows are affected, ask a doctor for advice on how to treat these areas.
Tell your doctor or pharmacist if you are pregnant or breastfeeding as some treatments may not be suitable.
Re-apply the same treatment after 7 days. Although lice are usually killed by one application, not all eggs may be treated successfully. The second application makes sure that any lice that hatch from eggs that survived the first application will be killed before they are old enough to lay further eggs. Avoid sex or close body contact with partner until you have both finished the second treatment application, otherwise you could be re-infected.
Itching often takes a few days to settle after successful treatment. An antihistamine medicine may help to ease the itch.
If treatment does not work another treatment type may need to be used as lice can develop resistance.
Currently there is no evidence that complementary therapies can treat 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 if infected. Remember, 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 clinic staff about how you feel.
