Pubic lice

Many STIs have no symptoms. It's important to get tested if you think you may be at risk.

Pubic lice are tiny parasitic insects that live in coarse body hair, such as pubic hair.

They're yellow-grey and about 2mm long. They have a crab-like appearance, so they're often known as crabs. The eggs appear as brownish dots fixed to coarse body hair.

Getting pubic lice is common. They're different from the head lice which some people get on their scalp.

Getting pubic lice is common. They're easily passed from one person to another through close body contact or sexual contact.

Some people won't have any symptoms, or may not notice the lice or eggs, so you may not know whether you or a partner have pubic lice.

It can take several weeks after coming into contact with pubic lice before signs and symptoms appear. You might notice:

  • itching in the affected areas
  • brown eggs on pubic or other body hair
  • irritation and inflammation in the affected area, sometimes caused by scratching
  • sky-blue spots (which disappear within a few days) or very tiny specks of blood on the skin.

You might see the lice, eggs or droppings.

Some people see pubic lice move, but they're tiny and difficult to see, and they keep still in the light.

Sometimes pubic lice will be noticed during a routine genital or medical examination.

Pubic lice are easily passed from one person to another through close body contact or sexual contact with someone who has them.

  • Pubic lice have nothing to do with poor hygiene.
  • They can be found in pubic hair, underarm and leg hair, hair on the abdomen and chest, beards and, rarely, in eyebrows and eyelashes. They don't live in the hair on the head.
  • Because pubic lice depend on human blood for survival, they'll rarely leave the body unless there's close body contact with another person.
  • They move by crawling from hair to hair – they can't fly or jump.
  • Occasionally pubic lice may be spread by contact with clothing, bedding and towels that've been used by someone with pubic lice.

You can have a check-up as soon as you have signs or symptoms for a doctor or nurse to look at, or if you think you might've been in contact with pubic lice.

Some people won’t develop visible signs or symptoms straight away and you may be asked to come back for another appointment later on.

What does the check-up involve?

In most cases, a doctor or nurse can tell if you have pubic lice just by looking.

They may use a magnifying glass to look for lice and eggs, which are very small and may not be easily visible.

The doctor or nurse may pick up a louse from the hair or skin and look at it under a microscope to check it's a pubic louse.

Where can I get a check-up?

There are a number of services you can go to. Choose the one you feel most comfortable with.

A test can be done at:

  • a genitourinary medicine (GUM) or sexual health clinic
  • your general practice
  • some contraception and young people’s clinics.

If you know you have pubic lice you can go to a pharmacy for advice and treatment.

Treatment for pubic lice is simple and involves using a special cream, lotion or shampoo. The doctor, nurse or pharmacist will advise you on what treatment to use and how to use it.

  • You apply the treatment to the affected area and sometimes the whole body. Lotions tend to be more effective than shampoos.
  • Some treatments can be rinsed off after 10–15 minutes; others are left on for longer.
  • To be effective, treatment needs to be repeated after 3–7 days.
  • You don't need to shave off pubic or other body hair.
  • You should wash your clothing, bedding and towels in a washing machine on a very hot cycle (60°C or higher) to kill the lice and avoid re-infection.
  • You can also buy treatments for pubic lice from pharmacies – these are useful if you're sure you have pubic lice and want to self-treat. The pharmacist will be able to advise if you have any questions, or are unsure how to use the treatment.
  • If you decide to treat yourself, you may still want to consider having a sexual health check to make sure you don’t have a sexually transmitted infection.
  • Do tell the doctor, nurse or pharmacist if you are, or think you might be, pregnant or if you're breastfeeding. This will affect the type of treatment you're given.
  • There's currently no evidence that complementary therapies can cure pubic lice.
  • Your sexual partner(s) should be treated at the same time even if they don’t have any signs and symptoms.

Will I have to pay for tests and treatment?

All tests are free through NHS services. Treatment is also free unless you go to your general practice when you may have to pay a prescription charge for the treatment.

You'll have to pay for treatments that you get directly from the pharmacy.

When will the signs and symptoms go away?

If you use the treatment according to the instructions, it's rare for it not to work.

Even after successful treatment, itching may continue for a few days.

There may be lice in your body hair after treatment but these can be removed with a special comb that you can get from a pharmacy.

Do I need to have a check-up to see if the pubic lice have gone?

No. If you've used the treatment as instructed, washed your clothing, bedding and towels and your sexual partner(s) have also been treated then the treatment should have been successful.

If you still have symptoms or are concerned you still have pubic lice, it would be advisable to have a further check-up about a week after treatment. You may need additional treatment as the lice can develop resistance to treatments.

Can pubic lice go away without treatment?

No. And if you delay seeking treatment you risk passing the condition on to someone else.

If you have pubic lice then your sexual partners should be treated at the same time even if they don’t have any signs and symptoms.

How soon can I have sex again?

It's strongly advised that you don't have any sexual intercourse, including vaginal, anal or oral sex, or close body contact, until you and your partner(s) have finished the treatment and any follow-up treatment. This is to help prevent you being reinfected or passing the infection on to someone else.

Will I know how long I’ve had pubic lice?

Sometimes it can be difficult to know where you got pubic lice from. The check-up can't tell you how long you've had them.

If you feel upset or angry about having pubic lice, don’t be afraid to discuss how you feel with the staff at the clinic or general practice.

Does having pubic lice affect my fertility?

No.

What happens if I get pubic lice when I’m pregnant or while I’m breastfeeding?

Pubic lice can be treated while you're pregnant or breastfeeding, but not all types of treatment can be used. Your doctor, nurse or pharmacist will advise you.

Permethrin cream is safe to use but if you're breastfeeding will need to be thoroughly washed off before any feed and re-applied if necessary.

Do pubic lice cause cervical cancer?

No. Pubic lice don't cause cervical cancer.

It's possible to get a sexually transmitted infection (STI) by having sex with someone who has an STI, even if they have no symptoms.

The following measures will help protect you from most STIs including chlamydia, gonorrhoea and HIV.

If you have a sexually transmitted infection they’ll also help prevent you from passing it on to someone else.

  • Use external condoms or internal condoms every time you have vaginal or anal sex. How to use condoms.
  • If you have oral sex, use a condom to cover the penis, or a latex or polyurethane (soft plastic) square to cover the anus or female genitals.
  • Avoid sharing sex toys. If you do share them, wash them or cover them with a new condom before anyone else uses them.
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This website can only give you general information about sexually transmitted infections. The information is based on evidence-based guidance produced by The British Association for Sexual Health and HIV (BASHH).

If you’d like information on the evidence used or would like to give feedback, email feedback@fpa.org.uk

Contact your doctor, practice nurse or a clinic if you're worried or unsure about anything.