Pubic lice (crabs): symptoms, treatment and who to notify
Pubic lice, also called crabs, live in pubic hair and feed on blood. They are annoying, but they are not serious and are removed with a simple treatment. Because they spread through close contact, it is important that your partner is treated at the same time so you do not pass them back and forth.
What are pubic lice?
They are lice (Pthirus pubis), yellowish-gray, 1 to 2 millimeters long and shaped a bit like a crab. They grip the hair with their claws and lay eggs (nits) at the base of the hair. Besides the pubic area, they can be found in the hair on the legs, chest, armpits, beard, eyebrows or eyelashes, but usually not on the head.
Pubic lice symptoms
- Intense itching in the genital area, which tends to get worse at night.
- Lice or nits visible at the base of the hairs.
- Small bluish spots on the skin or blood spots on underwear from the bites.
- Irritation or inflammation from scratching.
Symptoms can take a few days or a few weeks to appear after infestation.
How do pubic lice spread?
Mainly through intimate contact during sex. Condoms do not protect, because they pass from hair to hair. Less often, they spread by sharing clothes, towels or bedding. They are not passed on by animals, and having them is not a sign of poor hygiene.
Diagnosis
An examination of the area, sometimes with a magnifying glass, to see the lice or nits is usually enough. Because they are passed on during sex, it is a good idea to get tested for other STIs too.
Pubic lice treatment
They are treated with lice-killing lotions, creams or shampoos, for example with permethrin, which are sold at the pharmacy. Apply them following the instructions to all affected hairy areas, except the eyelashes, and repeat the treatment after 7 to 10 days if there are still lice or nits. If they are on your eyelashes or eyebrows, see your doctor.
To avoid getting them again:
- Wash the clothes, towels and bedding you have used in the last few days at 60 °C (140 °F) and dry them on a hot setting.
- Put anything that cannot be washed in a sealed bag for at least 72 hours.
- Do not have sex until you and your partners have finished treatment.
How to tell your partner you have pubic lice
Even if it feels embarrassing, tell them right away: if your partner is not treated at the same time, you will pass them back to each other. Some tips:
- Be direct and keep it low-key: it is common, it is not serious and it clears up in a few days.
- Explain what they need to do: check themselves, use the treatment, wash the bedding and not have sex until it is finished.
- Suggest treating yourselves at the same time, on the same day.
If you cannot tell a casual partner yourself, you can send them an anonymous text message or email with STI notice, without your name or number appearing.
Who should you notify?
The people you have had sex or intimate contact with in the last month. If you share a bed, towels or clothes with someone, they should check themselves too.
If you have been told you might have pubic lice
In good light, check your pubic hair and other hairy areas for lice or nits. Even if you see nothing, if you have recently had intimate contact with someone who has pubic lice, ask at the pharmacy or see your doctor: it is usual to be treated at the same time. Wash your bedding and towels and avoid sex until you have finished treatment.
Frequently asked questions about pubic lice
How long does it take to get rid of pubic lice?
With treatment they are usually gone within a few days. Check the area after a week to see whether the treatment needs repeating. The itching may last a little longer.
Do I need to shave to get rid of pubic lice?
No. Lice treatment is enough, although trimming or shaving the hair can make it easier to remove the nits.
Are pubic lice the same as head lice?
No. They are a different species, adapted to coarse hair such as pubic hair.
Other sexually transmitted infections
Syphilis · Gonorrhea · Genital herpes · HIV · HPV and genital warts · Chlamydia · Yeast infection (candidiasis) · Hepatitis A, B and C · Trichomoniasis · Scabies · Mpox (monkeypox)
Sources: MedlinePlus: pubic lice; CDC: ectoparasitic infections treatment guidelines.Health information updated in October 2026. It does not replace advice from a healthcare professional.