Pubic lice (crabs)

Pubic lice, or crab lice, infest pubic hair. They can also sometimes affect the hair of the armpit, eyebrows, eyelashes, beard and torso. The infection is also called pediculosis pubis and the lice are called Phthirus pubis.

Pubic lice are small, flat, light-brown parasites that cling to pubic hair and suck blood for nourishment. Blood sucking from pubic lice can cause small red areas or sores and itching. Pubic lice are usually sexually transmitted through direct skin-to-skin contact, including sexual activity. However, they can also be spread by contact with towels, undergarments and bedding of an infected person.

Lice infestation causes no serious harm, but can be irritating. If you have pubic lice, it is a good idea to get tested for other sexually transmissible infections.

Symptoms
The main symptom is itching of the affected area. This is often worse at night. Lice and nits (eggs from the lice) can sometimes be seen, especially stuck to the pubic hairs. Some people have no symptoms and may be unaware of the lice infestation.

Diagnosis
Pubic lice are diagnosed by careful inspection of the affected area.

Treatment
Topical creams or lotions containing permethrin (for example, Lyclear cream or Quellada lotion) and applied to the affected area are the most commonly recommended treatment. See your doctor, pharmacist or sexual health centre for further advice.

Permethrin should not be applied to the eyelashes. If this area is affected, discuss an alternative treatment such as petroleum jelly with your doctor.

Treatment tips
Treatment for public lice will be more effective if a few simple guidelines are followed:

• Usually the whole body from neck to toes should be treated, including the perineum (the skin between the vagina and the anus) and the anal area.
• Read and follow the instructions on the medication carefully.
• The skin should be cool, clean and dry when the cream is applied.
• Apply the cream and leave it on overnight. It can be washed off the next morning. You don’t need to apply the cream to head hair.
• Wash clothing, towels and bedding at the same time as treatment (hot machine washing and drying is sufficient).
• The treatment should be repeated after one to two weeks as it is not effective against unhatched eggs. Eggs hatch in 6–10 days.
• Avoid close personal contact until you and your contacts or partner are treated.

• Melbourne Sexual Health Centre Tel. (03) 9341 6200 or 1800 032 017 or TTY (for the hearing impaired) (03) 9347 8619
• Your doctor
• Your local community health centre

• Pubic lice are usually sexually transmitted through direct skin-to-skin contact.
• Pubic lice do not voluntarily leave the body and will need to be treated with a cream or lotion that contains permethrin.
• Do not use insecticides used in the home as these will not work and can damage the skin.
• Lice infestation causes no serious harm, but it is advisable to be tested for other sexually transmissible infections.

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