Pubic Lice: Care Instructions

Pubic lice near pubic area, with close-up of louse and eggs (nits)

Overview

Pubic lice are tiny bugs that usually live in your pubic area. Sometimes they're also found on facial hair, eyelashes, eyebrows, armpits, chest hair, and the scalp. But they're different than body lice or head lice. Pubic lice are often called "crabs" because they look like tiny crabs.

Millions of people get pubic lice every year. It doesn't mean you're not clean.

Pubic lice eggs (nits) are often easier to see than live lice. They look like tiny yellow or white dots attached to the pubic hair, close to the skin. Nits can look like dandruff. But you can't pick them off with your fingernail or brush them away.

Pubic lice can easily spread from one person to another. Pubic lice are usually spread through sexual contact. But sometimes they can spread through shared clothes, bedding, or towels. Pubic lice can't live away from a human body for very long. And they can't live on smooth surfaces.

Pubic lice can be uncomfortable and inconvenient, but they're not dangerous. They may cause itching and marks around the pubic area or other areas where they are found.

You can treat lice at home with prescription or over-the-counter medicines. After treatment, your skin may still itch for a week or more. This is because of your body's reaction to the lice.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Use the medicine, body lotion, or shampoo that your doctor recommends. Use the treatment exactly as directed. Some medicines need just one treatment. Others require follow-up treatments.
  • Check the area again 7 to 10 days after the first treatment. If you find live lice, you may need a second treatment. This is to make sure all lice are killed, including those that hatched since the first treatment.
  • Make sure to get tested for other sexually transmitted infections.
  • Try not to scratch. Use an over-the-counter anti-itch cream to calm the itching. If the itching is really bad, ask your doctor about an over-the-counter antihistamine. Be safe with medicines. Read and follow all instructions on the label.
  • If you want to remove nits after treatment, use a special comb. The combs are often packaged with over-the-counter lice shampoos. You can also shave the affected hair.

How can you help prevent pubic lice?

  • Machine-wash bedding, towels, and clothes in hot water (at least 130°F [54.4°C]). Dry them in a hot dryer. If you don't have access to a washing machine or if the items can't be washed or dried, store these items in a sealed plastic bag for 14 days.
  • Vacuum your home, including mattresses. You don't have to do other special deep cleaning.
  • Avoid sexual contact until you've successfully treated the lice.
  • Tell all your sex partners from the last month that you have pubic lice. Talking about this may be uncomfortable. But it will help prevent you from spreading the lice back and forth.

When should you call for help?

Call your doctor now or seek immediate medical care if:

  • You have signs of a skin infection, such as:
    • Increased pain, swelling, warmth, and redness.
    • Red streaks coming from an area of your skin.
    • Pus draining from an area of your skin.
    • A fever.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You see live lice or new nits after you have followed the directions for your medicine.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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