Crabs (Pubic Lice): What Causes Them and How to Treat It

When most people think about lice, they imagine the tiny bugs that can infest the scalp. However, pubic lice, often referred to as crabs, are a different type of lice that affect the pubic region and other body hair. Although they’re not a sexually transmitted disease (STD) in the strictest sense, pubic lice are often spread through sexual contact and are commonly considered a type of STD.

At Miami Beach Urgent Care, we understand the embarrassment and discomfort that can come with this condition. Let’s break down what pubic lice are, how they spread, and what steps you can take to treat and prevent them.

What Are Pubic Lice (Crabs)?

Pubic lice (scientific name: Pthirus pubis) are tiny parasitic insects that live on coarse body hair, especially in the pubic area. They are about the size of a pinhead, with a distinct crab-like appearance, which is how they earned the nickname “crabs.”

Unlike head lice, which live on the scalp, pubic lice are adapted to live in coarse body hair. They bite the skin and feed on blood, which causes itching and irritation. Pubic lice are most commonly found in the pubic region, but they can also infest other coarse hair on the body, such as the armpits, chest, legs, and even eyebrows and eyelashes.

How Do Pubic Lice Spread?

Pubic lice are typically spread through sexual contact. Intimate contact is the most common mode of transmission, as the lice are usually transferred from one person to another through the direct exchange of bodily fluids during sex.

However, pubic lice can also be spread through non-sexual means, although this is less common:

• Shared bedding or towels: Lice can live on clothing, bedding, and towels, so if you share these items with an infested person, you may be at risk.
• Infested clothing: Wearing clothing or underwear that has been in contact with someone who has pubic lice may also result in transmission.

It’s important to note that pubic lice do not spread through casual contact, such as handshakes or hugging. The lice are not found in the environment, and they need a host (usually human hair) to survive.

Symptoms of Pubic Lice

The main symptom of pubic lice is itching in the affected area, caused by the lice’s bites and the body’s reaction to their saliva. However, other symptoms can include:

• Visible lice or eggs: You may see the lice themselves, which are small, brown, or grayish. Eggs (nits) may also be visible on the hair shafts.
• Red or blue spots: As the lice feed on blood, they can cause irritation and small red or blue spots on the skin.
• Inflammation: Constant scratching may lead to inflammation, sores, or secondary infections due to broken skin.

How to Diagnose Pubic Lice

If you suspect you have pubic lice, it’s important to get a proper diagnosis. A healthcare provider will typically:

• Examine the affected areas (usually the pubic region, armpits, chest, or thighs) to look for visible lice or their eggs (nits).
• Microscopic examination: In some cases, a healthcare provider may use a microscope to confirm the presence of the lice or nits.

If you see lice or experience itching, it’s important to avoid scratching too much, as this can lead to skin infections.

Treatment for Pubic Lice

The good news is that pubic lice are treatable, and the treatment options are generally effective. Treatment usually involves medications or topical creams to kill the lice and eggs. Here’s a breakdown of the common treatments:

1. Over-the-Counter (OTC) Treatments:
   • Permethrin cream or pyrethrin-based products are often used to treat pubic lice. These treatments kill the lice and eggs. Apply the product to the affected area as directed, and follow the instructions carefully.
2. Prescription Treatments:
   • If OTC treatments aren’t effective, a doctor may prescribe stronger medications, such as malathion lotion or benzyl alcohol lotion, which are designed to kill lice more effectively.
   • In rare cases, ivermectin (an oral medication) may be prescribed for severe infestations.
3. Home Remedies:
   • While not scientifically proven, some people use home remedies like tea tree oil or mayonnaise to treat pubic lice. These should only be considered as adjunct treatments, and you should consult a healthcare provider first.
4. Shaving:
   • Shaving the affected area may be necessary to remove lice and eggs more easily. However, keep in mind that lice can also infest other areas of the body, so shaving won’t cure the infection by itself.

Steps for Treating Pubic Lice at Home

If you’ve been diagnosed with pubic lice, follow these steps to treat the infestation:

1. Use the recommended treatment as directed, whether it’s a prescription medication or OTC cream. Be sure to cover all areas where lice are present.
2. Wash all affected clothing, bedding, and towels in hot water (at least 130°F) to kill any lice or eggs.
3. Avoid sexual contact until the treatment is complete and all lice are gone. This will help prevent the spread of the infection to others.
4. Reapply the treatment as necessary, usually 7–10 days after the initial treatment, to ensure all lice and eggs have been killed.
5. Check for lice regularly in the weeks following treatment to ensure the infestation has been completely eradicated.

Preventing Pubic Lice

To avoid getting pubic lice in the future, you should:

• Limit sexual partners and use barrier methods (such as condoms) to reduce the risk of transmission.
• Avoid sharing personal items, such as towels, underwear, or bedding, with someone who has pubic lice.
• Get tested for STDs regularly, especially if you have new sexual partners or unprotected sex.

When to See a Doctor

If over-the-counter treatments don’t work, or if you have concerns about the condition, it’s important to see a doctor. Also, seek medical help if:

• The itching becomes severe or the skin becomes infected due to constant scratching.
• You’re having trouble treating the lice or experiencing an unusual reaction to the treatment.
• You’ve had pubic lice in the past and the infestation has returned.

Conclusion

Pubic lice (crabs) are a common, but easily treatable, condition caused by a small parasitic insect that infests the pubic region and other coarse body hair. They’re typically transmitted through sexual contact, but can also be spread through shared bedding and towels. If you’re dealing with pubic lice, don’t panic—treatment is available and highly effective.

At Miami Beach Urgent Care, we provide confidential testing, treatment, and guidance to help you manage pubic lice and other sexual health concerns. If you think you have pubic lice or need help with treatment, call us at +1 305-344-2273, or walk in for fast, discreet care.