Pubic Lice - Causes, Symptoms, Diagnosis, and Treatment

What Are Pubic Lice?

Pubic lice, commonly called crabs (because their bodies resemble tiny crabs), are small parasitic insects found in pubic hair near the genital areas. They can be found on other sites with body hair, such as legs, armpits, mustache, chest, beard, eyebrows, or eyelashes. In children, pubic lice are located in the eyebrows or eyelashes. They are spread through close contact, such as sexual activity. Crabs feed on the blood and cause severe itching but are treatable and do not cause serious health concerns. Pubic lice do not spread diseases, but they are itchy. They may end up with bacterial infections due to scratching. Scratching can break the skin letting the bacteria enter the skin and cause an infection.

What Causes Pubic Lice?

Pubic lice are most commonly spread through sexual contact and occur mostly in adults. Sometimes, pubic lice may transmit by close personal contact or by sharing articles such as clothing, bedding, or towels of a person used by and who has them. However, one cannot get pubic lice through casual contact like handshakes, hugs, or kisses. It is a misconception that pubic lice are spread by sharing a toilet seat. The lice cannot live very long when away from a human body, and their feet cannot adhere to smooth surfaces such as a toilet seat. People having pubic lice should be examined for the presence of other sexually transmitted diseases.

What Do Pubic Lice Look Like?

Pubic lice have three different forms:

• Nit: Nits are lice eggs. They are oval-shaped and usually yellow to white. They can be hard to spot and are found firmly adhered to the hair. Pubic lice nits take 6 days to 10 days to hatch.

• Nymph: The nymph is an immature louse that hatches from the nit. Nymphs feed on blood to survive and take about two-three weeks to hatch into mature adults capable of reproducing.

• Adult: The adult pubic lice have six legs; the front legs are larger and resemble a crab's claws. That's why they are also called "crabs." Adult lice are tan to grayish-white colored. Lice must feed on blood to live.

What Are the Symptoms of Pubic Lice?

Symptoms may appear about 2 to 5 days after contact:

• Severe itching in the areas covered by pubic hairs; itching usually worsens at night. Itching happens because pubic lice make small bites on the skin. An allergic reaction to these bites causes itchiness.

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• Scratching causes inflammation and irritation of the skin.

• Specks of blood in underwear.

• Lice bites cause pale blue spots on your thighs, buttocks, or lower abdomen.

• Tiny white dots on pubic hair that are hard to remove.

• Low fever.

How Are Pubic Lice Diagnosed?

Though they are small and hard to spot, one can see the lice. If you have symptoms of pubic lice but cannot visualize it, you must see a healthcare provider for a diagnosis. The healthcare provider may use a magnifying glass to spot the lice. Careful examination of pubic lice on the eyebrows or eyelashes of children is necessary as it can be a sign of sexual transmission or molestation. Adults with pubic lice may need to test for other sexually transmitted infections (STIs).

Are There Any Complications of Pubic Lice?

Occasionally, pubic lice can lead to minor complications, such as skin or eye problems. Untreated, long-standing pubic lice infestations can cause a person to feel unwell. Severe scratching can sometimes lead to impetigo (common bacterial skin infection) or furunculosis (boils on the skin). In addition, eye infections, such as conjunctivitis, can sometimes develop if eyelashes are infested with pubic lice.

How To Treat Pubic Lice?

Pubic lice can be easily treated at home using a cream, lotion, or shampoo without a prescription. They are safe and effective. Follow all the directions given on their packages.

A few steps to get the best results from pubic lice treatment are:

• Look for lice in hairy parts of the body. Wash and towel dry the body. Lice can quickly move away from one hairy body part to another. Shaving cannot get rid of pubic lice.

• Apply the shampoo, cream, or lotion on all the sites with pubic lice like thighs, underarms, lower abdomen, and buttocks. Avoid using shampoos on eyelashes.

• Leave the shampoo or cream on the hair for the time recommended in the instructions later, and rinse it off by following the instructions carefully on the label or in the box.

• Remove nits from hair strands or shafts using fingers or a fine-toothed comb.

• Clean your clothes, towels, bed linens, and towels using your washer and dryer's hot water and hot cycles to destroy any lice or nits. Those items that cannot be laundered can be dry-cleaned or stored in a sealed plastic bag for two weeks.

• Avoid using spray insecticide on your clothes or other objects in your house.

• Avoid sexual activity until the treatment is completed and ensure that the lice are gone before resuming sex. Pubic lice usually go away after about two weeks.

• Wear clean underwear and clothing after treatment.

• Repeat the treatment regimen in nine to ten days if the lice are still found.

• Persons with pubic lice should get themselves tested for other sexually transmitted diseases (STDs).

How To Prevent Pubic Lice?

Since pubic lice most commonly are spread from person to person by sexual contact, the best way to prevent them is to avoid close physical contact with people.

The following steps can help prevent and control the spread of pubic lice:

• Avoid having sex or physical contact with someone who has crabs, and avoid having sex with people with multiple sex partners.

• Ensure your partner gets treated if he had a pubic lice infestation. Finish treatment and check that the lice are gone before resuming sex.

• Wash and dry clothing, bedding, and towels in hot water. Non-washable items can be dry-cleaned or sealed in a plastic bag and stored for two weeks.

• Do not use insecticide sprays. They do not control crabs and can be harmful.

• Wear clean underwear and clothing.

What Is the Outlook or Prognosis for Pubic Lice?

Pubic lice do not cause serious health problems. The main problem is that the lice cause severe itching and discomfort, leading to a bacterial infection. The proper treatment regimen should get rid of the lice. See a doctor if you cannot get rid of pubic lice.

Conclusion

Pubic lice or crabs often are annoying and cause discomfort, but it is easy to treat them. Pubic lice do not cause serious health problems. Consult a doctor if you are not sure you have lice or if you end up getting a bacterial infection due to severe scratching. One can easily follow some reasonable steps to lower the risk for pubic lice and prevent them from returning.