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    Pubic lice

    Pediculosis - pubic lice; Lice - pubic; Crabs

    Pubic lice are tiny insects that infect the pubic hair area and lay eggs. These lice can also be found in armpit hair and eyebrows.


    Pubic lice are known as Phthirus pubis.They arefound mostly in teenagers. Pubic lice are often spreadduring sexual activity.

    Rarely, pubic lice canpassed through contact with objects such as toilet seats, sheets, blankets, or bathing suits at a store.

    Animals cannot spread lice to humans.

    Other types of lice include:

    • Body lice
    • Head lice

    You are at greater risk for public lice if you:

    • Have many sexual partners
    • Have sexual contact with an infected person
    • Share bedding or clothing with an infected person


    Pubic lice causes itching in the area covered by pubic hair. Itchingoften gets worse at night. The itching may start soon after getting infected with lice, or it may not start for up to 2 - 4 weeks after contact.

    Other symptoms can include:

    • Skin reaction that causes skin to turn bluish-gray in color
    • Sores in the genital area due to bites and scratching

    Exams and Tests

    The health care provider will do an exam to look for:

    • Small gray-white oval eggs (nits) attached to the hart shafts in the outer genital area. Adult lice may also be present.
    • Scratch marks or signs of an infection, such as impetigo.

    Because pubic lice may cause an eye infection (blepharitis) in young children, eyelashes should be viewed with a high-powered magnifying glass.

    Adult lice may be easily identified under the microscope. Public lice are often referred to as "the crabs" because of their appearance.

    Teenagers with pubic lice may need to be tested for other sexually transmitted infections (STIs).



    Pubic lice are best treated with a prescription wash containing permethrin, such as Elimite or Kwell:

    • Thoroughly work the shampoo into drypubic hair and surrounding area for at least 5 minutes.
    • Rinse well.
    • Comb the pubic hair with a fine-toothed comb to remove eggs (nits). Applying vinegar to pubic hair before combing may help loosen nits.

    Most people need only 1 treatment. If a second treatment is needed,it should be done 4 days to 1 week later.

    Over-the-counter medicinesto treatlice include Rid and Nix. Malathione lotion is another option.


    While you are treating pubic lice:

    • Wash all clothing and bedding in hot water.
    • Spray itemsthat cannot be washed may be sprayed with a medicated spray that you can buy at the store. You can also seal itemsin plastic bags for 10 - 14 days to smother lice.
    • Makes sure anyonewith whom you have had sexual contact or shared a bed be treated at the same time.

    People with pubic lice should be checked for other sexually-transmitted infections whenlice are discovered.

    Outlook (Prognosis)

    The proper treatment, including thorough cleaning, should get rid of the lice.

    Scratching can make the skin become raw, or even cause a skin infection.

    When to Contact a Medical Professional

    Call for an appointment with your health care provider if:

    • You or your sexual partner has symptoms of pubic lice
    • You try over-the-counter lice treatments and they are not effective
    • Your symptoms continue after treatment


    Avoid sexual or intimate contact with people you know have public lice until they have been treated.

    Bathe or shower often and keep your bedding clean.Avoid trying on bathing suits while you are shopping. If you must try on swimwear, be sure to wear your underwear. This may prevent you from getting or spreading public lice.


    Burkhart CN, Burkhart CG, Morrell DS. Infestations. In: Bolognia JL, Jorizzo JL, Schaffer JV, et al, eds.Dermatology. 3rd ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 84.

    Diaz JH. Lice (pediculosis). In: Mandell GL, Bennett JE, Dolin R. Mendell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa:Churchill Livingstone Elsevier;2009:chap 293.


    • Crab louse, female


    • Pubic louse-male


    • Crab lice


    • Head louse and pubic lou...


      • Crab louse, female


      • Pubic louse-male


      • Crab lice


      • Head louse and pubic lou...


      Review Date: 11/20/2012

      Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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