Medically reviewed by Alan Lucks | MD, Alan Lucks MDPC Private Practice - New York on February 1st, 2026.
Pubic lice are small parasitic insects primarily found in genital hair
Transmission occurs through close physical contact, not just sexual activity
Effective treatments include topical medications and thorough cleaning
Early detection and communication with partners are crucial for management
Pubic lice, colloquially known as "crabs," represent a common yet often misunderstood sexually transmitted infection affecting millions worldwide. These tiny parasitic insects create significant discomfort and embarrassment for those affected. Understanding their characteristics, transmission, and treatment is essential for proper management and prevention.
While many individuals feel anxious about discussing pubic lice, healthcare providers emphasize that this condition is treatable and does not indicate poor personal hygiene. Modern medical approaches focus on compassionate, straightforward care and comprehensive education.
Pubic lice measure approximately 1-2 millimeters in length, with a distinctive crab-like appearance featuring six legs and two large front claws designed for gripping hair shafts. Their grayish-brown coloration can shift to a rust-colored hue after feeding, making detection challenging without careful examination.
The most notable visual indicators include:
Small, moving insects in pubic hair
Nits (eggs) attached closely to hair shafts
Yellowish-white or brown specks near hair roots
Potential rust-colored excrement spots on underwear
Contrary to popular belief, transmission of pubic lice can occur without having sex. While sexual contact remains the primary method of spread, these parasites can also transfer through shared clothing, bedding, or towels. They survive approximately 24-48 hours away from human body heat, making indirect transmission possible.
Risk factors include:
Multiple sexual partners
Sharing personal items
Close physical contact
Living in crowded environments
The primary symptom of pubic lice infestation is intense itching, typically beginning five days after exposure. This sensation results from an allergic reaction to lice saliva and intensifies during nighttime hours. Urinary tract infections (UTIs) and sexual activity can sometimes complicate or exacerbate symptoms.
Common manifestations include:
Persistent genital itching
Small blue bite marks
Redness and skin irritation
Potential secondary bacterial infections from scratching
Effective treatment involves both medical intervention and environmental management. Over-the-counter treatments containing permethrin or pyrethrins serve as the first-line defense. A comprehensive approach includes:
Topical medication application
Washing all potentially contaminated fabrics in hot water
High-heat drying of clothing and bedding
Potential prescription medications for resistant cases
Treatment Type |
Method |
Effectiveness |
Duration |
|---|---|---|---|
OTC Treatments |
Topical lotions/creams |
High |
7-10 days |
Prescription Medications |
Malathion/Lindane |
Very High |
As directed |
Environmental Cleaning |
Hot water wash |
Supplementary |
Ongoing |
Prevention focuses on communication and careful personal hygiene. Birth control and sexual health consultations can provide additional guidance for managing potential exposures.
Key prevention tips include:
Avoiding sharing personal items
Communicating with sexual partners
Regular medical check-ups
Immediate treatment upon detection
Pubic lice can spread rapidly through close physical contact, typically within 24-48 hours of exposure.
While uncomfortable, pubic lice are generally not medically dangerous and are easily treatable.
Yes, they can spread to chest, armpit, and facial hair in some cases.
Off the human body, they survive approximately 24-48 hours.
With proper treatment and thorough cleaning, pubic lice can be completely eradicated.
Care you can trust. Doctronic is clinically validated with 99% treatment plan alignment.
Pubic lice, colloquially known as "crabs," represent a common yet often misunderstood sexually transmitted infection affecting millions worldwide. These tiny [...]
Read More
