Pubic lice (also called "crabs") are tiny insects that live in hair around the genitals. They can also live in eyelashes, eyebrows, beards, armpit hair, and other body hair. They usually spread through sex. Less often, they spread when someone touches infested clothing, towels, and bedding. Pubic lice can easily be treated with over-the-counter or prescription medicines. They are not dangerous and do not spread disease.

Treatment:

• For prescription medicines, use cream, lotion, or shampoo exactly as the health care provider recommended.
• For over-the-counter medicines, follow the directions that come with the treatment.
• Most treatments for pubic lice need to be used more than once. So it's very important to follow directions exactly.
• Wash clothes, towels, and bedding that you have used. Wash them in hot water and dry them in a hot dryer. Or you can put the items in a sealed bag for 2 weeks.
• Tell all sexual partners from the past 2 months to get treatment too, even if they don't have signs of pubic lice. That way it won't spread back to you or other people.
• Don't have sex again until you and your sexual partners have been treated and have no symptoms.

Follow up:

• Follow your health care provider's instructions about getting tested for other sexually transmitted diseases (STDs) (also called sexually transmitted infections or STIs).
• Get all doses of the human papillomavirus (HPV) vaccine (shot). HPV is an STD that can lead to some kinds of cancer and genital warts.

• You still have symptoms or find live lice 2 weeks after treatment.
• You develop signs of a bacterial infection in the skin where you have scratched, such as sores that are red, swollen, painful, or filled with pus.

What are the signs of pubic lice? Pubic lice usually cause itchiness. This can get worse at night when the lice become active. Sometimes, lice bites can lead to skin redness and irritation. Lice in the eyelashes or eyebrows can cause eye itchiness and redness. Although they are very small, you can see the lice and their eggs (called nits) if you look carefully.

How are pubic lice diagnosed? A health care provider usually diagnoses pubic lice by looking at the insect and its eggs. If needed, the insect can be sent to a lab for identification.

How can I avoid getting pubic lice again? Because pubic lice usually spread during sex, not having sex is the best way to avoid them. Condoms do not protect against pubic lice because the lice live outside of the area that condoms cover. Not sharing clothing, bedding, or towels also can help reduce the risk of getting pubic lice.