Pubic Lice

What are pubic lice?

Pubic lice (often called 'crabs') are tiny insects about 1mm long (just smaller than a pinhead). They are grey or brown in colour. They lay eggs which hatch into lice after 7 days. Pubic lice attach strongly to hairs, and do not wash or brush off with normal cleaning.

They commonly affect the pubic hair. However, they may also affect hair around the anus, underarm hair, beards, chest, and body hair. Eyelashes and eyebrows are occasionally affected. Scalp hair is a different type of hair, and is not usually affected. (A different kind of louse called the head louse is the one that can infect scalp hair.)

How do you get pubic lice?

You need close contact to pass pubic lice on to others. Sexual contact is the common way. However, close contact with family or friends may be a cause. For example, you may 'catch' pubic lice by hugging someone with an infected beard or moustache. Pubic lice are not passed on from clothing, bed linen, or toilet seats as they die if they are away from the body.

What are the symptoms of pubic lice?

• The main symptom is itch in the affected areas. This is usually in the pubic hair area. The itch may take several days to begin after you become infected.
• Faint blue spots may appear on the nearby skin.
• Skin irritation and scratching may cause redness or a rash in affected areas.
• You may develop eye inflammation if your eyelashes or eyebrows are affected.
• Some people have no symptoms, but can still pass lice on to others without realising.

What is the treatment for pubic lice?

You can buy a lotion or a cream that kills the lice from pharmacies. You can also get them on prescription. They are easy to apply and normally work well if used properly. Follow the instructions on the packet. The following is a general guide giving tips for success.

• You should treat all your body below the neck as the lice can spread and affect many parts of your body. You should treat beards and moustaches, but not other areas of the head, eyes, or mouth.
• An average adult needs about 100 ml of lotion or 30-60 g of cream to treat the whole body. A small paintbrush is a good way of applying lotion (but use cotton wool to apply lotion to sensitive areas such as the penis).
• If you use a lotion, a water based lotion is best as alcohol based lotions may sting.
• Apply lotion or cream to cool, dry skin.
• You should leave the lotion or cream on for the full recommended time, and then wash off. Depending on which one you use, this may be up to 12-24 hours. It is common to apply treatment at bedtime, and wash it off after the correct time the next day.
• If you wash any part of your body during the treatment period, you should re-apply the lotion or cream again to the washed areas.
• You do not need to shave the affected areas. The lotion or cream will clear the lice.
• Some people advise washing bed linen, towels, and clothes (particularly underwear) which has been used since a week before symptoms started. There is no good evidence that this is necessary, but some people prefer to do it.
• If your eyelashes or eyebrows are affected, ask a doctor for advice on how to treat these areas.
• Tell your doctor or pharmacist if you are pregnant or breastfeeding as some treatments may not be suitable.

Re-apply the same treatment after 7 days. (Although lice are usually killed by one application, not all eggs may be. The second application makes sure that any lice that hatch from eggs that survived the first application will be killed before they are old enough to lay further eggs.)

Do family and friends need treatment?

Ideally, recent close contacts and sexual partners should be examined for lice and treated if infected. Remember, you can have pubic lice without symptoms.

Some other points about pubic lice

• Itching often takes a few days to settle after successful treatment. An antihistamine medicine may help to ease itch. Your pharmacist can advise.
• Consult a doctor if symptoms persist after the second application of lotion or cream.
• Avoid close body contact with others until you finish the second treatment application.
• Your doctor may advise that you are tested for other sexually transmitted diseases if a sexual contact is the likely cause of pubic lice.

Further help and information

If you suspect that you have pubic lice or any other a sexually transmitted disease, then see you GP or contact your local Genito-Urinary Medicine (GUM) clinic. You can go to the local GUM clinic without a referral from your GP. You can ring the local hospital or health authority and ask for the details of the nearest clinic. It may also be listed in the phone book under 'Genito-Urinary Medicine'.

Web resources
www.ssha.info - Society of Sexual Health Advisers
Information and images on sexually transmitted infections and related issues for the public and professionals. Includes contact details of all the GUM clinics in the UK and Ireland.

© EMIS and PIP 2004   Updated: August 2003   CHIQ Accredited   PRODIGY Validated