Pubic Lice
2-minute consultation reviewed by a UK clinician
We check your answers and recommend a suitable option
Plain packaging to your door, fast and confidential
Pubic Lice
They live in coarse hair all over the body, not just the pubic area — which is why treating one region fails, and why a sexual health check belongs alongside.
Key fact: Pubic lice do not live on the head, and they are not confined to pubic hair. They infest coarse body hair — chest, abdomen, armpits, beard, and occasionally eyelashes — which is why treatment covers far more of the body than most people expect.
What pubic lice are
Pthirus pubis, commonly called crabs, is a louse adapted to coarse, widely spaced body hair. It is a different species from the head louse and does not live on the scalp.
The lice are small — around 2mm — broad, and crab-shaped, with claws sized for thicker hair. They feed on blood and cannot survive long away from a human body.
Where they live
| Commonly affected | Not affected |
|---|---|
| Pubic hair | Scalp hair — the hair is too fine and too densely packed |
| Hair on the chest and abdomen | — |
| Armpits | — |
| Facial hair — beard and moustache | — |
| Eyelashes and eyebrows, occasionally | — |
| Coarse hair on the legs and back | — |
This is the single most practical fact about pubic lice. Because they occupy any coarse hair, treating the pubic area alone frequently fails — the lice are simply elsewhere on the body, and they walk back.
Symptoms
- Itching, usually worse at night — an allergic reaction to louse saliva, which can take a week or more to develop
- Small red or blue spots on the skin, which are bite marks
- White or yellow dots stuck to the hair — the eggs, firmly cemented to the hair shaft
- Dark red or brown specks in underwear — louse droppings
- Lice visible if you look closely, moving slowly at the base of the hair
- Sometimes nothing at all, particularly early, which is why partners are checked regardless
How they spread
- Close body contact, usually sexual — this is the dominant route by a wide margin
- Condoms do not prevent it, because transmission is skin and hair contact rather than fluid exchange
- Rarely from clothing, bedding or towels used by someone infested. Possible, but uncommon
- Not from toilet seats, and not from animals
- Nothing to do with hygiene
How it is confirmed
By seeing the lice or their eggs. Unlike some conditions, this one is visible if you look properly:
- Good light and, ideally, a magnifier
- Look at the base of the hairs, where lice attach to feed
- Eggs are cemented and will not slide along the hair, unlike debris
- Check all coarse hair, not only the pubic area
- Do not treat on itching alone — several other things itch in the same place
Is it pubic lice? covers what else causes genital itching, including scabies, which is the closest mimic and needs a different treatment.
Treatment
| Detail | |
|---|---|
| What is used | An insecticide cream, lotion or shampoo — typically permethrin or malathion, the latter available as Derbac-M |
| Where applied | All coarse body hair, not just the pubic area — chest, abdomen, armpits, beard, legs where hair is coarse |
| Left on for | 12 hours, or overnight, before washing off |
| Repeated | Again a week later, to kill lice hatched since |
| Never on | The eyebrows or eyelashes |
As with head lice and scabies, the second application is not optional — eggs already laid are relatively protected and hatch over the following days. Treatment, partners and testing covers the application in full.
Eyelashes and eyebrows
Do not put insecticide treatment on the eyebrows or eyelashes. Eyelash infestation is uncommon but does occur, and it is managed differently — usually with a thick occlusive ointment applied by a clinician, and sometimes by physical removal. If you can see lice or eggs on the lashes, that needs assessing rather than treating at home.
Eyelash involvement in a child is a specific situation that always warrants a careful, sensitive assessment rather than treatment alone.
Partners and testing
- Current and recent sexual partners should be checked by a healthcare professional, even without symptoms
- Treat at the same time where lice are found, so nobody reinfests anyone else
- Avoid close or sexual contact until treatment is complete and no lice remain
- A full sexual health check is recommended — pubic lice indicate the kind of contact that transmits other infections, and co-infection is common
The testing point is the one worth taking seriously. Pubic lice are a nuisance; what may have arrived alongside them is not. Chlamydia, genital herpes and genital warts are all considerably more consequential and frequently silent.
Clothing and bedding
- Wash clothes, bedding and towels at 50°C or hotter, on the day of treatment
- Or dry-clean them
- Or seal them in a plastic bag for at least 2 weeks, which outlasts anything that could hatch
- Repeat on the day of the second application
- Nothing more elaborate is needed — lice do not survive long off a person
Afterwards
- Itching can continue for a week or two after successful treatment, because it is an allergic reaction that outlasts the lice
- Check again a week after the second application — live lice at that point mean treatment failure
- Empty egg cases may remain attached to hair and are not evidence of ongoing infestation
- Shaving is not necessary and does not treat the infestation, since lice occupy hair elsewhere too
- Do not repeat treatment for itch alone — repeated applications irritate skin and worsen the itch
Get assessed rather than self-treating if: lice or eggs are visible on the eyelashes or eyebrows; you are pregnant or breastfeeding; the affected person is a child, which needs a careful assessment of how it was acquired; the skin is broken, weeping or crusted, suggesting secondary infection; or two correctly applied courses have not cleared it.
Frequently Asked Questions
Where do pubic lice live on the body?
In coarse body hair: pubic hair, and also hair on the chest, abdomen, armpits, face and occasionally the eyelashes. They do not affect scalp hair, which is too fine and densely packed. This is why treatment has to cover all coarse body hair rather than the pubic area alone.
How do you get pubic lice?
Almost always through close body contact, usually sexual. Condoms do not prevent transmission, because it happens through skin and hair contact rather than fluids. They can rarely be caught from clothing, bedding or towels used by someone infested, but not from toilet seats or animals.
How are pubic lice treated?
With an insecticide cream, lotion or shampoo applied to all coarse body hair, left on for 12 hours or overnight before washing off, and repeated again a week later to kill lice that have hatched since. Treatment must never be used on the eyebrows or eyelashes.
Do my partners need treating?
Current and recent sexual partners should be checked by a healthcare professional even if they have no symptoms, and treated at the same time if lice are found. Avoid close or sexual contact until treatment is complete and no lice remain.
Should I get tested for other infections?
Yes, a full sexual health check is recommended. Pubic lice indicate the kind of close contact that transmits other sexually transmitted infections, co-infection is common, and several of those infections are more consequential and frequently have no symptoms at all.
Do I need to shave to get rid of pubic lice?
No. Shaving is not necessary and does not treat the infestation, because the lice also occupy coarse hair elsewhere on the body, including the chest, abdomen and armpits. Correct application of treatment to all coarse hair, repeated after a week, is what clears it.
References
- NHS. Pubic lice. nhs.uk
- National Institute for Health and Care Excellence. Clinical Knowledge Summary: Pubic lice. cks.nice.org.uk
- IUSTI. European guideline for the management of pediculosis pubis. iusti.org
- British Association for Sexual Health and HIV. Clinical guidelines. bashh.org
- NHS. Sexually transmitted infections (STIs). nhs.uk
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Insecticide treatments must never be used on the eyebrows or eyelashes. Pubic lice are usually sexually transmitted, so a full sexual health check is part of the assessment. Always consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999.
