Pubic lice or "crabs" are small grey or brownish-red insects. They are typically are found attached to hair in the pubic area, but sometimes are found on eyebrows, eyelashes, beards, mustaches, the chest, and armpits.
Itching in the pubic and groin area is the most common symptom of pubic lice. Like other lice infestations, itching can lead to scratching, which can cause sores and skin infections.
Other signs of crabs are visible lice eggs ("nits"), crawling lice that maybe attached to pubic hair or other hairy areas of the body.
If you have a bad case of pubic lice, you might have a mild fever and feel sick.
Pubic lice do not transmit disease; however, scratching can lead to sores and a possible infection of the skin. Some people may notice bluish spots in the pubic area or on the inner thighs where the pubic lice bite. Dried spots of blood can also be found on a person's underwear, along with fine black particles of feces and live lice eggs ("nits").
Remember to always practice safer sex and use condoms. This will lower the risk of getting any STIs.
To prevent pubic lice ("crabs"), avoid having sexual contact or sharing bedding or clothing with anyone who has an infestation. If you are being treated for pubic lice, all sexual partners must also be treated. It's important to follow all of the instructions that come with any treatment for crabs.
It is also important for other people who live in the same home to check for crabs. If they have crabs, they will need to be treated at the same time so that they will not reinfect you after you have completed the treatment.
Do not have sex again if you or your partner(s) have not fully completed treatment or if you still have symptoms.
If you have concerns about telling your partner(s), contact a public health nurse. The public health nurse can suggest ways to handle the situation. Your privacy will be respected.
Crabs usually are spread through sexual contact and are most common in adults. Occasionally pubic lice may be spread by close personal contact or contact with clothing, bed linens, and towels that have been used by a person who has crabs.
It is very rare for crabs to be spread by contact with a toilet seat since they can live for only 1 to 2 days off of the human body.
Anyone can get crabs, though it is most common among sexually active people and in situations where individuals are in close contact. Crabs are not related to poor hygiene or social status.
Pubic lice are diagnosed by finding a "crab" louse or egg (nit) on pubic hair or, less commonly, on eyebrows, eyelashes, beards, mustaches, armpits, the perianal area, groin, trunk, and scalp.
Although pubic lice and nits can be large enough to be seen with the naked eye, you may need a magnifying lens to see them.
If you have crabs, you should get tested for sexually transmitted infections (STIs).
Without the right treatment, pubic lice ("crabs") will not go away. Ordinary soap and water will not kill them. Pharmacies have over the counter cream and shampoo treatments. Following treatment, the crabs will usually be killed but may leave some eggs ("nits") attached to the hair shafts. Nits should be physically removed by using a fine-toothed comb or with your fingernails. Shaving alone may not get rid of the problem.
Clothes, bedding, and other possible contaminated items should be washed in hot water (50°C) and dried at the hottest setting, dry cleaned, or put into plastic bags and sealed for two weeks. Items that cannot be washed or bagged, such as sofas, mattresses and rugs should be thoroughly vacuumed.
Treatment for pubic lice ("crabs") should be repeated if live crabs are found 9 to 10 days after your first treatment.
If you decide to talk to your partner(s) yourself, learn how to talk comfortably about it.