Pubic Lice: Causes, Symptoms, Treatment

Also known as crabs, pubic lice are tiny insects that grow in your genital area. There are three types of lice that can cause irritation in the human body. They are:

• Pthirus pubis: Pubic lice
• Pediculus humanus corporis: Body lice
• Pediculus humanus capitis: Head lice

These lice live on human blood and cause intense irritation in affected areas. 

Usually, crab lice live on your pubic hair and spread through sexual contact. Rarely, they can be found on your facial hair, eyelashes and armpit hair. 

Most commonly, crab lice are seen in people with sexually transmitted infections.

Symptoms of Pubic Lice

If you have pubic lice, you may experience intense skin irritation and itching in your genital area or anus. This itching can get severe at night. 

You may also experience:

• Pale bluish spots near the bites
• Detect lice on your scalp, pubic hair and clothes
• Low-grade fever
• Irritability
• Find lice eggs or ‘nits’ on your hair shafts
• Red bumps often show up on your scalp, neck or shoulder
• Lack of energy

What Causes Pubic Lice?

Pubic lice cannot swim, fly or jump, they can only crawl. 

They can only be transmitted by one person to another in the following ways: 

• Sharing towels, bedding, and other personal items
• During sexual activity
• Through nonsexual bodily contacts, such as hugging or kissing

These lice can spread from one part of the body to another on the hands, for example, if you touch your pubic hair.

There are several factors that can increase the risk of developing crab lice. However, keep in mind that not all people with these risk factors will get these lice. 

Risk factors include:

• Multiple sexual partners
• High-risk sexual behaviour
• Sharing clothing or towels with someone who has pubic lice
• Sexual contact with someone who has pubic lice

Diagnosing the Condition

When you experience severe itching, you must visit your family doctor and get it checked. 

Before diagnosing pubic lice infestation, your doctor will perform a physical examination of your pubic area. Your doctor may use a magnifying glass to look for lice. 

Usually, these lice are pale grey in colour but may darken in colour after drinking your blood. Probably, you are infested with lice if you see crab-like insects moving in your pubic hair.

These lice may lay eggs in your pubic hair. The eggs are tiny and white in colour, usually found around the roots of your pubic hair or any other body hair. 

Get medical help if you experience itchiness and irritation around your pubic hair.

Treatment for Pubic Lice

Your doctor may prescribe a few medicines and recommend insecticide cream, lotion or shampoo. 

Your doctor may help you with all the instructions regarding your treatment plan and recommended products. It is important that you follow the advice given by your doctor.

Some insecticide cream or lotion can be applied to the infected area, sometimes the whole body, avoiding the eye area.

If these do not help eliminate lice, your doctor may recommend suitable alternatives. Your doctor may prescribe strong treatments such as:

• Lindance: It is usually prescribed only after other treatments fail due to its toxicity. You may apply it on the affected area and rinse off after a few minutes. This drug is not suitable for infants or young children, elder people, pregnant and breastfeeding women. 
• Malathion: Malathion is a prescription-based lotion that you may need to apply on the affected area and rinse off after a few hours.
• Ivermectin: This drug is used as a single dose of two pills, with an option to take another dose after 10 days, only after the first dose is ineffective. 
• Eyebrow and eyelash treatments: If your doctor detects pubic lice in your eyelashes or eyebrows, you will be prescribed petroleum jelly. You will be asked to use it carefully with the help of a cotton swab at night and rinse it off in the morning. Ensure you apply it carefully as it may cause irritation to eyes if used incorrectly.

As a basic habit, ensure you always keep your pubic hair, armpit hair and facial hair clean. Keep them clean and get medical help if you see any lice or experience any irritation. Keep in mind shaving will not help in treating these lice.

Lifestyle Changes To Prevent Recurrence

As pubic lice most commonly spread directly from person to person by several means, ensure you avoid certain things, such as:

• Sharing clothes, bedding, towels and even toilet seat
• Choose your sexual partners wisely
• Sexual contact with an infected person should be avoided strictly
• Wash your clothes in hot water and the high heat drying cycle. Items that are not washable can be dry cleaned or sealed in a plastic bag and kept it away for 2 weeks
• Avoid or limit the usage of fumigant sprays or figs as they may not necessarily help control lice but can be toxic if inhaled
• Keep the infected area clean and dry
• Use medications recommended by your doctor
• Use clean underwear and clothes after treatment
• If you are infested, try informing all sexual partners that they are at risk for infestation and must get treatment immediately
• If you have any STDs and STIs, get medical help to detect crab lice

Home Remedies for Pubic Lice

You can try these home remedies to treat pubic lice:

• Olive oil: Olive oil contains potent nutrients that can suffocate lice and prevent them from coming back. A study ranks olive oil as the most effective remedies. Apply olive oil only after consulting your doctor.
• Tea tree oil: Tea tree oil contains antimicrobial properties that can effectively eliminate these crab lice. There are certain studies that suggest that tea tree oil can be an effective home remedy, but it needs more research to confirm its effectiveness on crab lice. 
• Mayonnaise: Although mayonnaise is popularly used to treat lice after it aired on the US version of ‘The Office’, a few researchers believe it can smother lice and make it easier for a person to comb their hair. Some people also claim that mayonnaise helped ease the itchiness and scalp irritation from lice. However, researchers are conducting several research studies to prove the effectiveness of mayonnaise. 
• Coconut oil: Coconut oil not only helps to treat dry skin and hair but also to get rid of pubic lice. 
• Anise oil: Anise oil may suffocate lice like olive oil. A study claims anise oil to be one of the effective natural remedies for lice in children. Anise oil can help you eliminate lice permanently. 

Before using these remedies, you must always confirm once with your health expert. 

Learn more about STDs here.