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Sexually Transmitted Infections

Pubic Lice ('crabs')

These tiny insects can live in body hair (except on the head).

They spread easily through body-to-body contact, especially during sex.

They are itchy and uncomfortable and can cause skin infections.

Pubic lice are treated with creams or lotions.

What are pubic lice and how are they caught?

Pubic lice (Phthirus pubis) are tiny parasites that live only on human blood. Under a magnifying glass, they look a bit like crabs - hence their nickname.
 
Their bites can be very itchy. They can infest hair around the genitals, on legs, the chest, back, armpits and sometimes in beards, eyebrows or eyelashes.
 
In rare cases, their bites can cause eye infections.
 
They spread through:
  • sexual contact
  • hugging and kissing
  • sharing towels, beds or bed linen
  • on clothes, especially underwear.

How can I avoid catching pubic lice?

Avoid physical contact or sharing clothes, beds or towels with anyone you know has pubic lice.
 
Male or female condoms do not give any protection against pubic lice.

How can I tell if I have pubic lice?

You may notice:
  • itching in the affected area
  • inflammation caused by scratching
  • black powder in your underwear (lice poo)
  • tiny bloodspots on your underwear
  • small blue dots on the skin (these are the healing bites)
  • the insects moving or clinging to hairs (adults are around 2mm long)
  • tiny pale brown eggs stuck to hairs
  • white, empty egg cases ('nits') stuck to hairs.
If you think you may have pubic lice, you should get tested.

Pubic lice testing

Testing for pubic lice is by physical examination.
 
This can be done by your GP or practice nurse or at your local sexual health service.
 
If you do have pubic lice, you should consider being tested for other sexually transmitted infections.

Pubic lice treatment

Except around the eyes, pubic lice treatment is with special lotion, cream or shampoo containing insecticide. 
 
The doctor or nurse will advise you how to use your treatment and whether second treatments are needed.
 
These treatments are available from your doctor and from pharmacies. 
 
Always follow the instructions carefully. Seek advice from your doctor if you are pregnant or breastfeeding or are under 18.
 
You should avoid physical contact with anyone else until you have finished treatment and know you are free of lice.

Find out more about pubic lice

For more information on symptoms, diagnosis and treatments, visit the NHS Choices pages on Pubic Lice