Pubic Lice (Crabs)

Symptoms

People with pubic lice or crabs can experience severe itchiness in the genital area. The crabs might also infest other body parts that have coarse hair, such as:

• Chest
• Legs
• Armpits
• Beard or moustache
• Eyelashes or eyebrows (more common among children)

Causes

Pubic lice mostly spread from one person to another during sexual contact. They can also be contracted through infested sheets, towels, blankets, or clothes.

Risk Factors

Individuals with other sexually transmitted infections (STIs) are at a higher risk of having pubic lice as well.

Complications

While crab infestations are generally treatable using louse-killing gels or lotions, they can sometimes cause complications, including:

• Discoloured skin: Pale blue spots are likely to appear in areas that the crabs have continuously fed from.
• Secondary infections: Scratching itchy bites can lead to raw wounds that might become infected.
• Eye irritation: Minors with crabs on their eyelashes are at risk of developing conjunctivitis (a form of pink eye).

Diagnosis

A visual examination of the genital area is generally enough for you or your healthcare provider to confirm a crab infestation. If moving lice are present, it indicates an infestation. In addition, lice eggs (or nits) can signify an infestation. Even after an effective course of treatment, nits may remain attached to hairs, though they aren’t alive anymore.

Treatment

If non-prescription lotions or shampoos containing 1% permethrin (Nix) or pyrethrin fail to eliminate pubic lice, the doctor can recommend stronger options such as:

• Malathion: This prescribed lotion should be applied to the infested region and washed off after 8 to 12 hours.
• Ivermectin (Stromectol): This medication should be taken as a single dose of two pills. If the treatment doesn’t work the first time, another dose can be taken in ten days.
• Eyelash and eyebrow treatments: Pubic lice in eyebrows and eyelashes can be treated by cautiously rubbing petroleum jelly using a cotton swab at night and then washing it off in the morning. One might need to repeat this treatment for a number of weeks. However, if not properly applied, it could irritate the eyes.

If the pubic lice and nits are fewer, they can be removed with fingernails or a nit comb. Additionally, if further treatment is required, the doctor can recommend a topical ointment. Every hairy part of the body needs to be meticulously assessed and treated, as lice can migrate from treated regions to other hairy areas. Shaving will not, however, eliminate pubic lice.

Self-Care

Pubic lice can be eliminated through a patient and comprehensive approach involving cleaning oneself and all contaminated personal items.

Consider the following steps to get rid of lice infestations:

• Using lotions and shampoos: There are many available over-the-counter products like lotions and shampoos (Nix) that can eliminate lice. Follow the instructions carefully. Additionally, the treatment might need to be repeated in 7 to 10 days.
• Cleaning contaminated belongings: Thoroughly wash your clothing, towels, and bedding used during the past two days before the treatment with hot, soapy water of about 130°F (54°C). After that, dry them under extreme heat for 20 minutes.
• Dry cleaning or sealing non-washable belongings: Items that cannot be washed should be dry cleaned and placed in an airtight bag for at least 2 weeks.

Prevention

The best way to prevent a crab infestation is to refrain from sexual activity and sharing clothing or bedding with an infected person. If you are undergoing treatment for pubic lice, ensure that your sexual partners also receive treatment.

Preparing for Your Appointment

Consider consulting the family doctor if you are unable to eliminate crabs on your own.

What You Can Do

Before visiting the doctor, make a list of answers to these questions:

• For how long have you had pubic lice?
• What signs and symptoms do you have?
• How did pubic lice infect your body?
• Are you sexually active, or have you shared towels or sheets since discovering you have lice?
• Have you tried any treatments?
• Do you have any chronic medical conditions?

What to Expect from Your Provider

Your doctor will examine your genital area during a physical exam for signs of crabs or viable nits.