Are you worried you or someone you know may have pubic lice (crabs)? If you’re confused about what pubic lice is, what its symptoms are, and how to treat it, keep reading. We’ve got everything you need to know about crabs STD.

Pubic lice (aka crabs): What they look like? How you get them? Symptoms, causes, treatment, pictures and much more. Find out all about this STD in our article.

Pubic Lice – Crabs STD

Pubic Lice (Crabs STD)

Pubic lice are small insects that invade the genital area. They’re also called crabs. These tiny insects feed on human blood. They cause intense itching in the infected areas. There are about 3 million cases of pubic lice in the United States each year.

The pubic lice live on pubic hair. They’re a sexually transmitted disease (STD) meaning they spread through sexual contact. In rare instances, they’re found in armpit hair, eyelashes, and facial hair. They rarely infest head hair. Pubic lice most often are smaller than body and head lice.

Head, Pubic and Body Louse

It’s important to note that getting crabs doesn’t mean you have poor hygiene. Yes, pubic lice often infect people with sexually transmitted diseases. But, an infestation happens to people of all races, classes, and ethnic groups all over the world.

Pubic Lice (Crabs STD) Pictures

  • Crab louse or pubic louse (Pthirus pubis)
    Crab louse or pubic louse (Pthirus pubis)

Facts

Nit (egg) and Adult Pubic LouseThere are three types of pubic lice. There is the egg, also known as a nit, the nymph, and the adult. Below is a description of each one.

Nit

Lice eggs are nits. The nits attach to the hair shaft and are hard to see. They’re small ovals that are usually yellow to white in color. Females lay about 30 eggs during their lifespan of 3-4 weeks. Pubic lice hatch in 6 to 10 days.

Nymph

When the egg hatches, it’s a nymph. A nymph is a smaller version of an adult louse. A louse is a wingless insect that’s an external parasite. It survives by feeding on blood. The nymph takes between two and three weeks to mature into an adult. Once it’s mature, it can reproduce.

AdultPubic Lice Stages

Adults are flat and 1.5 to 2.0 mm long. They’re broader than head and body lice.

If you put an adult pubic louse under a magnifying glass, it looks like a miniature crab with six legs. The front legs are larger and look like crab claws. That’s how pubic lice got the name crabs. The adult pubic lice are grayish-white. The females are larger than the males. To survive, all the lice must feed on blood. A louse that falls off will die in a couple of days.

Pubic Louse (Pthirus pubis) Life Cycle

 

Causes

How do you get crabs? Pubic lice usually spread through sexual contact. Infestation is most common in the genital area on pubic hair. Yet, they invade hair on legs or armpits, as well as facial hair.

Pubic Lice

Pubic lice on the eyebrows or eyelashes of children may indicate sexual activity or abuse. Head lice are not pubic lice. Animals can’t get or spread pubic lice.

Most pubic lice spread through intimate contact, including sexual intercourse. It’s possible to catch pubic lice by sharing blankets, towels or clothing with someone who has them.

Remember, lice can’t survive away from a human body. They don’t fall off their human host unless they’re dead. They also can’t stick to a surface like a toilet seat or chair.

If you have a lice infestation, don’t share your bed or clothing.

Symptoms

Pediculosis pubisThe most noticeable symptom is itching. It usually starts about 5 days after someone gets crabs. The itching is in the genital region or anus. Itching can become more intense at night. Some other symptoms to watch for include:

  • Visible lice eggs or crabs
  • Low Energy
  • Pale blue spots near lice bites
  • Irritable
  • Low fever

Lots of itching can cause scratches or wounds in the infested areas. Children with eyelash infestations are at risk for conjunctivitis, aka pink eye.

Pubic Lice Symptoms

Pubic Lice Don’t Spread Disease

While pubic lice don’t spread disease, intense itching can lead to scratches and sores. Those open sores are vulnerable to bacterial infection.

Anyone with pubic lice should check for other sexually transmitted diseases.

Diagnosis

A pubic lice infestation diagnosis happens when you see a louse or eggs on hair in the pubic area. Less often, the crabs are somewhere else on the body. They can be hard to find if there are only a few. Pubic lice don’t crawl as fast a head and body lice. They attach to a hair and move slow.

Pubic Lice Diagnosis

While lice and nits often are large enough to spot, you’ll need a magnifying glass to find the eggs. If you suspect pubic lice, but are unsure, consult a healthcare professional.

 

Treatment

There are over-the-counter and prescription medications available to treat pubic lice. These lotions and shampoos treatments usually include 1% Permethrin in a lice-killing lotion. These products don’t need a prescription. Prescription medications are available if other treatments don’t work.

If you have a mild infestation you may only need to wash your pubic hair to kill the lice. Don’t rely on home remedies like shaving and hot baths to treat lice. They aren’t effective. Lice will survive a treatment of regular soap and water.

Pregnant or breastfeeding women should talk to a doctor before using any product. Do the same if you are treating an infant. You want to be sure the products are safe for you and your child.

Treat everyone in the household who has lice at the same time. Eradicate the lice all at once to reduce the chance of a repeat infestation.

NOTE: Never use regular lice medications near your eyes. Read instructions for lice found on eyebrows or eyelashes in the next section.

Crabs STD (Pubic Lice) Treatment

Time for humor. Crabs STD Treatment.

Step By Step Treatment

The first step is to disinfect yourself, your clothes, and your bedding. To make sure the lice are gone, follow these steps:

  1. Read the label directions. Over-the-counter treatments are safe and effective when you follow the instructions. Read the directions with care. Each one has different guidelines for use.
  2. Saturate the pubic hair and any other infested areas (except eyelashes and brows) with the lice medication. Leave it on the infected area for as long as instructed. Next, remove the medication according to the directions on the label.
  3. After a topical treatment, some lice eggs remain attached to your hairs. Use tweezers or a nit comb to remove them.
  4. Put on clean underwear and clothing after your treatment. Don’t risk a repeat infestation by wearing clothing that wasn’t cleaned yet.
  5. Kill any lice or eggs by washing all clothing, towels, and bedding in hot water (10 degrees). Dry everything on the hottest dryer setting available. If you can’t wash something put it in an airtight plastic bag for two weeks.
  6. Vacuum the entire house. Bleach the bathroom.
  7. Inform all sexual partners from the past 4-5 weeks that they are at risk for pubic lice.
  8. Avoid sexual contact until after treatment. Make sure you and your partners are free from repeat infestation.
  9. If you find live lice, repeat the treatment. You may want to use one of the stronger medications described below.
  10. Anyone with pubic lice should check for other sexually transmitted diseases (STDs).

If pubic lice survive all your efforts, you need stronger medicine. Keep reading for more options.

Prescription Medications

Malathion lotion 0.5% (Ovide) is a prescription medication. It’s a topical lotion that you leave on for 8 to 12 hours. Malathion lotion (Ovide) isn’t approved by the U.S. Food and Drug Administration (FDA) for treatment of pubic lice.

Ivermectin (Stromectol) is available as a two-pill dose taken by mouth, or as a topical lotion. Both treatments treat lice. Only the topical lotion has FDA approval. Oral Ivermectin isn’t FDA approved for the lice treatment.

The strongest prescription medication for treating pubic lice is Lindane. It’s so strong you only leave it on for four minutes.

Lindane shampoo isn’t recommended unless necessary. It can be toxic to the brain and nervous system. Lindane is a last defense option for people who can’t use other products.

People with seizure disorders, irritated skin, and open sores shouldn’t use Lindane. Infants, children, and the elderly, as well as pregnant and nursing women, should avoid it.

Pubic Lice Medications

Topical Drugs Used to Treat Pubic Lice
GenericsBrand Names
permethrinActicin, Elimite, Lice Bedding Spray, Nix Creme Rinse (Topical), Nix Lice Control, Nix, Nix Dermal Cream, RID Home Lice Control Spray for Surfaces
lindaneKwell, Thionex, Kwellada Lotion 1, Lindane, Pms-Lindane
piperonyl butoxide / pyrethrinsLice Treatment, RID, Licide, Tisit, Good Sense Lice Killing Shampoo – Step 1, A200 Maximum Strength, A200 Time-Tested Formula, Lice-X, Medi-Lice Maximum Strength, Pronto Maximum Strength, Pyrinex, Pyrinyl
spinosadNatroba

Special Instructions for Eyelashes and Eyebrows

If only a few pubic lice are in eyelashes, try tweezers or a nit comb. You may be able to pluck out the nits and lice. The best option is to see a doctor. The doctor can prescribe a lice medicine that’s safe for the eye area. Never use regular lice shampoos near eyes.

If needed, application of a prescription-strength ophthalmic petrolatum ointment may work. It’s applied to the eyelid area 2-4 times a day for 10 days. Don’t use regular vaseline since it can irritate eyes.

After treatment, itching may continue for a week or two. This is normal as your body reacts to the lice bites. Contact a doctor if you see swelling, discoloration, or drainage from open wounds.

Prevention

Pubic Lice PreventionMost often, pubic lice spread through direct sexual contact. To control and prevent spreading crabs, take the following steps:

  1. Anyone who had sexual contact with the infected person should be examined. Everyone who has lice should be treated.
  2. Avoid sexual contact until everyone is treated. Each person should be clear of persistent infestation.
  3. Don’t share clothing, bedding, and towels with an infected person.
  4. Don’t us fumigators or fogs to treat crabs. They don’t treat pubic lice and can be toxic if inhaled or absorbed through skin contact.
  5. Machine wash and dry clothing, bedding, and towels worn and used by the infested person. Use the 130-degree water, and the highest heat settings. Store unwashable items in a sealed plastic bag for two weeks.
  6. Anyone with pubic lice should be checked for other sexually transmitted diseases.

Pubic Lice Video

Frequently Asked Questions About Pubic Lice

What are Pubic Lice?

Pubic lice (also called crabs) are tiny parasitic insects. They feed on human blood to survive. They’re usually found living in the pubic area. Sometimes they’re found on hair on the chest, back, and armpits. They can be in facial hair including a beard, eyebrows, or eyelashes.

There are three types of lice that live on people. Pubic lice is one. The other two are head and body lice. Each type of lice is different. If you have one kind of lice it doesn’t mean you’ll get another kind.

What are the Symptoms of Pubic Lice?

Intense itching in the genital area is the most common symptom. A careful inspection reveals eggs or crawling lice.

The lice suck blood to survive. Their bites cause an allergic reaction and itching. If there are only a few crabs, it may take a while for the itch to irritate enough to suspect lice.

Everyone reacts differently to pubic lice bites. Some people have severe itching, others see blue spots on their skin near the bite. The spots appear a few hours after the bites and last for days.

How Do Crabs Spread?

Pubic lice crawl. They can’t hop or fly. They move from one person to another through sexual contact. It’s possible for lice to spread through contact with clothing, beds, bedding or towels used by someone with crabs. This is rare but can happen in close quarters.

You can’t get lice from animals. People and animals have different lice that can’t spread to each other. Pubic lice die if they’re removed from the body because they need to feed on blood to survive. Direct contact is the most common way lice spread.

Who Gets Crabs?

Pubic lice are most common in sexually active adults. There’s an association between people who get pubic lice and STDs like Gonorrhea or Chlamydia. If someone has crabs, inform the sexual partner so they can check for infection and get treatment.

Check children if they have infected parents.

Is It Pubic Lice?

The common way to diagnosis pubic lice is from seeing lice or eggs. But, it can be hard to find them if there are only a few. Sometimes you need a magnifying glass to see them. Anyone with a sexual partner who has lice should seek treatment.

How Do You Treat Pubic Lice?

The most common treatment for crabs is a lice-killing lotion or cream. Treatments are available without a prescription. They’re safe and effective when you follow the instructions.

One treatment usually eliminates the lice. Check for lice and eggs after treatment. If they aren’t eradicated, you need to repeat the treatment after 10 days. Choose a prescription medication if you need a stronger treatment.

Dr. Jack Johnson, MD