Pubic lice

Pubic lice

Pubic lice, also known as crabs, are tiny insects that live on coarse human body hair, such as pubic hair around the penis or vagina.

Pubic lice are not linked to poor personal hygiene.

Symptoms of pubic lice

It can take up to 3 weeks after coming into contact with pubic lice before you notice any symptoms.

The most common symptom of pubic lice is itchy red spots. The itching is caused by an allergy to the lice saliva or poo.

It can take 1 to 3 weeks for itching to develop after the first infestation, and it’ll usually be worse at night.

Public lice are very small (2mm long) and grey-brown in colour.

They’re hard to spot, but sometimes you may be able to see them in your hair. They live mostly on pubic hair, but can also be found in hair on the chest, armpits, face and eyelashes. They do not affect hair on your head.

You may also notice the following symptoms:

• small red or blue spots on your skin (lice bites)
• white or yellow dots attached to your hair (lice eggs)
• dark red or brown spots in your underwear (lice poo)
• crusty or sticky eyelashes, if they’re infected

When to get medical advice

Speak to your GP practice, local pharmacy or local sexual health clinic if:

• you think you might have pubic lice

Testing for pubic lice

If you think you might have pubic lice, get checked for free by:

• booking an appointment at your local sexual health service
• contacting your GP practice for an appointment

What does a pubic lice test involve?

There is no test for pubic lice. Your doctor or nurse will check your hair for lice. They may check your pubic hair around your penis or vagina and any other areas that could be affected.

To help spot any pubic lice, your doctor or nurse may use a comb and a magnifying lens.

You can also buy treatment over the counter at your local pharmacy although they will not be able to diagnose the infestation.

Treatment for pubic lice

Pubic lice are treated with medicated creams or shampoos that kill the lice.

You’ll usually need to use treatment on your whole body and leave it on for a few hours before washing it off. You’ll need to repeat this a week later to make sure all the lice have been killed.

You may be asked to come back to your GP practice or sexual health clinic once you’ve finished treatment to check the treatment has worked.

Your partner(s) should also be treated, even if they do not have symptoms.

Resistance

Some pubic lice can be resistant to treatment. Resistance means that the lice will not be affected by a particular treatment. If your symptoms don’t settle, you may need to try more than one type of treatment.

Speak to your GP practice or local sexual health clinic if your first treatment hasn’t worked.

Treatment of lice in the eye area

Treatment of lice in the eye area is usually different from elsewhere. Certain creams and lotions are not safe for use near the eye area. Lice here can be removed with tweezers or Vaseline can be used to suffocate the lice before removal.

Things you can do

While you’re being treated for pubic lice, there are some things you can do to help stop the lice from spreading.

Do

• wash your clothes and bedding on a hot wash (50 degrees or higher), have them dry cleaned or put them in a plastic bag for at least a week – this will help kill any lice
• hoover your mattress to remove any lice

Don’t

• do not share clothes, bedding or hygiene products (including razors)
• do not have any close body contact (including sexual contact) with anyone during treatment

How pubic lice are passed on

Pubic lice are spread through close body contact with someone who has them, most commonly sexual contact.

The lice crawl from hair to hair but can’t fly or jump. They need human blood to survive, so generally only leave the body to move from one person to another.

Pubic lice don’t live on other animals such as cats or dogs.

If you or your partner has pubic lice, you should avoid having sex (vaginal, anal or oral). You should also avoid close bodily contact. Do this until you’ve both finished treatment, including any follow-up treatment.

How to prevent pubic lice

Pubic lice are easily spread, and condoms don’t protect against them.

To reduce the risk of getting pubic lice, you should limit the number of people you have intimate or sexual contact with.

Other STIs

If you have been diagnosed with pubic lice you should get tested for other STIs including:

• gonorrhoea
• chlamydia
• syphilis