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Pubic Lice
Sexually Transmitted Disease Facts
Type of Infection: Also called "crabs," pubic lice are parasitic insects found in the genital area of humans. This condition is called pediculosis pubis.
Prevalence of Pubic Lice: An estimated 3 million people with new cases of the infestation are treated each year in the United States.
According to the US Centers for Disease Control, pubic "crab" lice infestation is found worldwide and occurs in all ethnic groups in all levels of society. Pubic lice usually are spread through sexual contact and are most common in adults. Occasionally pubic lice may be spread by close personal contact.
Pubic lice do not transmit disease, but infection can occur from scratching the skin.
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Modes of Transmission for Pubic Lice: Pubic lice are spread through sexual contact. Rarely, infestation can be spread through contact with an infested person's bed sheets, towels, or clothes.
Symptoms of Pubic Lice: Signs and symptoms of pubic lice include itching in the genital area and visible nits (lice eggs) or crawling lice.
Treatment for Pubic Lice: A lice-killing shampoo (also called a pediculicide) made of 1% permethrin or lindane is recommended to treat pubic lice. These products are available without a prescription at most local drug stores.
- Wash the infested area then towel dry.
- Thoroughly saturate hair with lice medication, and leave on for 4-10 minutes, according to directions. Thoroughly rinse off medication with water. Dry off with a clean towel.
- Following treatment, most nits will still be attached to to hair shafts. These may be removed with fingernails.
- Put on clean underwear and clothing after treatment.
- To kill any lice or nits (attached to hairs) that may be left on clothes or bedding, machine wash items that the infested person used during the 2-3 days before treatment. Use the hot water cycle (130° F). Use the hot dryer cycle for at least 20 minutes.
- Dry-clean clothing that is not machine washable.
- Inform any sexual partners that they are at risk for infestation.
- Do not have sex until treatment is complete.
- Do not have sex until partner has also been cured.
- Repeat treatment in 7-10 days if lice are still found.
Special Considerations about Pubic Lice: Infants, young children, and pregnant or lactating women should not be treated with lindane. They may be treated with permethrin, however, in consultation with a medical professional.
Prevention of Pubic Lice: Abstaining from genital sex with an infected person is the most effective means of preventing the sexual transmission of pubic lice. Neither latex condoms, nor typical birth control devices, provide protection from pubic lice. Bedding and clothing from an infected person should not be shared until decontaminated (i.e., either machine-washed or machine-dried using the hot cycle or dry-cleaned) or removed from body contact for at least 72 hours.
Source of Facts: CDC Fact Sheet, "Pubic Lice Infestation," U.S. Department of Health and Human Services, revised October 19, 2004.
Photo Sources: Centers for Disease Control and Prevention, Division of STD Prevention, "Lice & Scabies," STD Clinical Slides, 2003, www.cdc.gov/std/training/clinicalslides; Centers for Disease Control, Public Health Image Library (PHIL), phil.cdc.gov/phil.