Pubic Lice ("Crabs") – Symptoms, Treatment & Prevention

Pubic lice, more commonly referred to as “crabs”, are tiny parasitic insects that inhabit the coarse hairs of the human body, most frequently the pubic region. Despite the stigma surrounding them, pubic lice are not a reflection of poor hygiene. In fact, they can affect anyone who has close physical contact with an infested individual. Recognizing pubic lice symptoms early and accessing effective crabs treatment options are key to managing the condition and preventing further spread. This guide will cover what pubic lice are, how they are transmitted, symptoms to watch for, treatment strategies, and how to avoid getting them in the first place.

What Are Pubic Lice?

Pubic lice (Pthirus pubis) are small, six-legged insects that feed on human blood. They differ from head and body lice in both shape and preferred habitat. These lice are aptly nicknamed “crabs” because of their crab-like appearance and sideways movement. They tend to attach themselves to coarse body hair, particularly in the genital region, although infestations can also be found in armpit hair, leg hair, beards, chest hair, and in rare cases, eyelashes or eyebrows.

Each louse lives for about three weeks, during which time it can lay up to 50 eggs. The eggs, or nits, are cemented to the base of hair shafts and hatch within 6–10 days. Adult lice are typically around 1–2 mm long and are visible to the naked eye. Because they rely on blood for survival, they remain close to the skin and cause irritation at the feeding site. Though they do not transmit serious diseases, their presence can lead to itching, discomfort, and sometimes secondary skin infections. Knowing the life cycle of pubic lice helps understand why thorough crabs treatment is essential to eliminate both adult lice and eggs.

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What Do Pubic Lice Look Like?

Pubic lice are small, crab-shaped insects that are visible to the naked eye, though their size and colour can make them tricky to spot. Adult pubic lice are about 1–2 mm in length — roughly the size of a sesame seed and have a broad, flat body with six legs. The two front legs are noticeably larger and resemble crab pincers, which they use to cling tightly to coarse human hairs.

In terms of colour, they are usually pale grey or tan, but may appear darker after feeding on blood. Under close inspection or magnification, their movements may resemble a slow crawl rather than the rapid motion associated with fleas or head lice. The nits (lice eggs) are tiny, oval-shaped, and yellowish-white. They are firmly glued to the base of hair shafts, making them difficult to remove.

Because of their small size and tendency to remain close to the skin, they may be mistaken for dandruff, skin flakes, or scabs at first glance. A magnifying glass or dermatoscope can help confirm their presence. If you're unsure, a healthcare professional can assist in identifying them accurately during an examination.

Pubic Lice Symptoms

Recognizing pubic lice symptoms early can help reduce discomfort and prevent spread. The most common symptom is itching, caused by an allergic reaction to louse saliva. This itching often becomes intense and persistent, particularly in the pubic area. It may worsen at night when lice are more active. In some individuals, especially during their first infestation, symptoms may take several days to appear.

Additional pubic lice symptoms include small red or blue spots where the lice have bitten, which may resemble bruises. You may also notice black powdery droppings in your underwear, as well as white or yellowish eggs attached firmly to the base of pubic hairs. In more severe or long-standing cases, the constant scratching can cause skin irritation, swelling, or even bacterial infections. Some people also report a crawling sensation or discover lice during routine hygiene. Infestation of eyelashes can lead to red, irritated eyelids and may mimic blepharitis or conjunctivitis. In all cases, prompt recognition of pubic lice symptoms allows for earlier and more effective crabs treatment.

How Do You Get Pubic Lice?

Pubic lice are primarily spread through close physical or sexual contact. They cannot fly or jump; instead, they crawl slowly from one person to another when bodies or belongings come into contact. This is why sexual transmission is the most common route. However, pubic lice can also be passed through sharing towels, bedding, clothing, or even upholstered furniture, especially in communal living settings like hostels or dormitories.

It is important to note that pubic lice are not linked to poor hygiene. Even people who bathe regularly can get them. The lice prefer clean, coarse hair and a blood supply—both of which can be found on any person regardless of hygiene habits. In some cases, public transportation or shared seating areas may pose a low-level risk if there is direct contact with contaminated fabric shortly after use. While less common, pubic lice can also be contracted through non-sexual close physical contact, such as hugging or co-sleeping. Understanding the transmission helps reinforce why preventative measures and prompt crabs treatment are important after exposure.

Crabs Treatment Options

Treating pubic lice involves eliminating both the lice and their eggs, as well as preventing reinfestation. Most cases respond well to over-the-counter treatments available from pharmacies, though prescription options may be required for resistant infestations. The first-line crabs treatment is typically a topical insecticide such as permethrin 1% cream or a pyrethrin-based product. These should be applied to all affected areas and left on for the recommended time before rinsing off. A second treatment is usually advised 7–10 days later to kill newly hatched lice.

For more stubborn cases, your doctor may prescribe stronger treatments such as malathion lotion or oral ivermectin. If lice are found on the eyelashes, avoid over-the-counter products and seek medical care—ointments like petrolatum may be prescribed for safe application near the eyes.

In addition to treating the body, environmental cleaning is crucial. Wash all clothing, towels, and bedding used within the last two days in hot water (at least 50°C) and tumble dry on high heat. Items that can’t be washed should be sealed in a plastic bag for at least 72 hours to ensure the lice and nits are dead. Avoid physical or sexual contact until treatment is completed. Partners from the past month should also be informed and treated to prevent reinfestation. Following the full crabs treatment protocol ensures all lice and eggs are eradicated and reduces the chance of transmission.

How to Prevent Pubic Lice

Preventing pubic lice begins with awareness and practicing good personal and interpersonal hygiene. The most effective way to prevent lice is to avoid close physical contact with an infected person until they have been treated. In relationships, open communication about sexual health and symptoms plays a big role. Regular sexual health screenings, especially for those with multiple partners, can also help catch infestations early.

Additionally, avoid sharing items that come into close contact with the body, such as towels, bedding, or undergarments. When staying in hotels, hostels, or shared accommodations, it’s wise to inspect bedding and consider bringing your own towels. While condoms are important for preventing sexually transmitted infections, they do not protect against pubic lice, as the lice inhabit areas beyond condom coverage.

Maintaining vigilance after travel or new intimate contacts, checking for pubic lice symptoms, and treating any cases promptly will all contribute to keeping infestations at bay. Educating yourself and others about how lice spread and how to manage them can remove the stigma and empower people to act swiftly and responsibly.

When to See a Doctor

While many cases of pubic lice can be managed with over-the-counter products, there are situations where seeing a doctor is essential. If symptoms persist after completing the recommended crabs treatment, or if the lice are resistant to standard medications, a healthcare provider can prescribe stronger or alternative treatments. If you notice lice on your eyelashes or experience redness and discharge in the eyes, this requires medical attention, as the eyes are sensitive and require specialised treatment.

You should also seek help if scratching has caused open sores, scabs, or signs of secondary infection, such as increased redness, pus, or swelling. In rare cases, pubic lice symptoms may be confused with other conditions like eczema, scabies, or sexually transmitted infections. A doctor can perform an examination and confirm the diagnosis under magnification. In any case, timely professional guidance ensures a faster resolution and minimizes complications.

Final Thoughts

Though they are often whispered about and carry an unfair stigma, pubic lice, or crabs, are a common and treatable condition. Understanding the biology of pubic lice, recognizing the signs, and accessing prompt crabs treatment are key to resolving the issue effectively. With appropriate treatment, lice can be completely eliminated within a couple of weeks, and reinfection can be prevented through simple hygiene and communication.

Everyone deserves accurate and compassionate healthcare information—especially for topics that might feel embarrassing. By breaking the stigma around pubic lice symptoms and treatment, we promote a more informed and healthier community. If you think you might have pubic lice, don’t hesitate—speak with a healthcare provider or pharmacist and take control of your health today.