Summary

  • 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 may damage your skin.
  • Lice infestation causes no serious harm.
  • If you have pubic lice it is a good idea to be tested for other sexually transmissible infections.
     

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 transmitted through direct skin-to-skin contact during 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 of pubic lice

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 that they have a lice infestation.

Diagnosis of pubic lice

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

Treatment of pubic lice

Applying topical creams or lotions containing permethrin (for example, Lyclear cream or Quellada lotion) to the whole body from neck to toes is the most commonly recommended treatment. You do not need to apply the cream to the hair on your head. See your doctor, pharmacist or sexual health centre for further advice. 

Note: Do not apply permethrin to your eyelashes. If your eyelashes are affected, discuss alternative treatment with your doctor.

Treatment tips for pubic lice

You can treat pubic lice more effectively if you: 

  • read and follow the instructions on the medication carefully
  • make sure your skin is cool, clean and dry when you apply the cream
  • treat your whole body from neck to toes, including the perineum (the skin between the vagina and the anus) and the anal area. You don’t need to apply the cream to head hair
  • leave the cream on overnight and wash it off the next morning
  • wash clothing, towels and bedding at the same time as applying the treatment (hot machine washing and drying is sufficient)
  • repeat the treatment 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 sexual contacts or partners are treated.

Symptoms may take a few days to settle. If you still have symptoms one week after treatment, see your doctor for review.
Sexual partners should be treated for pubic lice

Any sexual partners you have had over the last month will need to be examined and treated. Current sexual partners should be treated at the same time that you are. Condoms do not protect you against pubic lice.

Where to get help

References

More information

Content Partner

This page has been produced in consultation with and approved by: Melbourne Sexual Health Centre

Last updated: March 2018

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