What Are Pubic Lice?

Pubic lice (also called “crabs”) are tiny parasitic insects that live in coarse human hair, especially around the genitals. They feed on blood and lay eggs (called nits) on the hair shaft. While they’re often grouped with sexually transmitted infections (STIs), pubic lice are technically parasites — not viruses or bacteria.

Pubic lice spread mainly through skin-to-skin contact, most commonly during sex. But they can also be passed through shared clothing, towels, or bedding. They don’t jump or fly — they crawl from one person to another.

How common are pubic lice?

Pubic lice used to be more common, but rates have declined in recent years, especially in places where people remove pubic hair. Still, they remain a global issue. According to the CDC, they affect millions of people each year, and anyone can get them — regardless of age, gender, or sexual orientation.

What Are Symptoms of Pubic Lice?

The most common symptom of pubic lice is intense itching in the genital area. This itching is caused by the lice biting the skin and feeding on blood, which triggers an allergic reaction. You might not notice anything for a few days to weeks after exposure — but once the itching starts, it’s usually hard to ignore.

In people with female biology:

• Itching in or around the vulva, anus, or thighs
• Small blue spots or tiny blood marks from bites
• Redness or irritation from scratching
• Presence of lice or eggs in pubic hair

In people with male biology:

• Itching around the scrotum, penis, or lower abdomen
• Visible nits (eggs) or crawling lice in pubic hair
• Sores or crusting from repeated scratching

In everyone:

• Lice can spread to other coarse hair, like chest, armpits, beard, eyebrows, or eyelashes
• Irritability or difficulty sleeping from persistent itching

What Do Pubic Lice Look Like?

Adult pubic lice are very small — about the size of a pinhead. Under magnification, they look like tiny crabs (hence the nickname), with a broad body and claw-like legs that help them cling to hair shafts.

• Lice appear tan, gray, or white and move slowly
• Nits (lice eggs) are oval and yellow-white; they stick tightly to the hair shaft and are hard to wash out
• Bite marks may appear as small red or blue spots

Most people can’t see the lice without a mirror and good lighting. If you’re not sure what you’re seeing, a healthcare provider can check with a magnifying tool.

How Are Pubic Lice Transmitted?

Pubic lice are spread primarily through close skin-to-skin contact, especially during sexual activity. They can also spread through:

• Shared bedding or towels
• Shared clothing, especially underwear

Unlike head lice, pubic lice are less likely to spread through casual contact, but it’s still possible if infested materials aren’t washed or cleaned.

Can you get pubic lice from a toilet seat?

Not likely. Lice can’t survive long away from the human body, and they can’t jump or fly.

Are pubic lice an STI?

They’re often considered a sexually transmitted infestation because they’re most often spread through sexual contact. But they’re caused by a parasite, not a virus or bacteria.

How Do You Test for Pubic Lice?

There’s no lab test or swab for pubic lice. Diagnosis is usually based on visual inspection.

How are they diagnosed?

• A healthcare provider examines the genital area for visible lice or eggs
• They may use a magnifying glass or dermatoscope for better visibility
• In cases involving eyelashes, a special eye exam may be needed

If you’re not sure what’s causing your symptoms, or you can’t see anything, a clinician can confirm the diagnosis — and rule out other causes like scabies or irritation.

How Are Pubic Lice Treated?

Treatment for pubic lice is simple and effective. You can usually get rid of them with over-the-counter or prescription medications.

Common treatments:

• Topical lice-killing lotions or shampoos, such as permethrin 1% cream rinse or pyrethrin-based products
• Repeat treatment after 7–10 days to kill newly hatched lice
• Wash clothing, bedding, and towels in hot water and dry on high heat
• Avoid sexual contact until treatment is complete and lice are gone

What about eyelashes?

If lice or nits are found in the eyelashes, don’t use regular lice shampoo — it can damage your eyes. Your provider may recommend removing lice with tweezers and applying a safe ointment.

Complications of Pubic Lice

Pubic lice don’t spread disease, but they can cause:

• Secondary skin infections from scratching
• Irritation or inflammation of the skin
• Emotional distress, embarrassment, or anxiety

Because pubic lice are often sexually transmitted, many providers will also recommend testing for other STIs if lice are found.

Outlook & Prognosis

With proper treatment, pubic lice go away quickly. Most people feel relief from itching within a few days, and lice are gone after 1–2 treatments. If symptoms persist, follow up with a provider.

You can get pubic lice again if you’re re-exposed. Treating your partner(s) and washing clothing and bedding helps prevent reinfestation.

Living With Pubic Lice

Getting pubic lice isn’t a reflection of your hygiene or character — it just means you had close contact with someone who had them. Lice don’t care how clean you are.

While it can feel uncomfortable or embarrassing, treatment is easy, and most people are back to normal quickly. If you’re dealing with persistent itching, don’t suffer in silence — talk to a provider.

In the meantime:

• Avoid shaving the affected area — it won’t cure lice and may worsen irritation
• Launder personal items and avoid sharing towels or clothing
• Be kind to yourself — this is treatable, and you’re not alone

How to Tell Your Partner(s) You Have Pubic Lice

Telling a partner about pubic lice might feel awkward, but it’s an important part of protecting their health — and yours.

Try saying:

“I found out I have pubic lice — sometimes called crabs. They’re tiny bugs that live in pubic hair and are usually spread through sex. I’ve started treatment and wanted to let you know so you can check in with your provider too.”

Let them know:

• Lice are very common and easy to treat
• It’s not about blame — it’s about preventing reinfection
• They should treat themselves and wash clothes or bedding if you’ve had contact

This kind of honesty shows responsibility and care — and most partners will appreciate that.

Last reviewed: May 2025
This content is regularly reviewed and updated to reflect the latest medical guidelines.

• Caused by: Parasitic insect (Pthirus pubis)
• Spread through: Skin-to-skin contact, especially during sex; also through shared towels, bedding, or clothes
• Symptoms: Intense itching, red or blue bite marks, visible lice or eggs in pubic hair
• Testing: Visual diagnosis — no swab or blood test needed
• Treatment: Over-the-counter lice shampoo or prescription creams; repeat in 7–10 days; wash clothes and bedding
• Risk if untreated: Ongoing discomfort, secondary skin infections, reinfection
• How common: Affects millions globally; still seen regularly in sexual health clinics