First the Facts

  • Pubic lice are common in the UK.
  • Anyone can get pubic lice; they have nothing to do with poor bodily hygiene and are not always spread through sexual contact.
  • It is possible to have pubic lice without any symptoms but still spread them to other people.
  • To get rid of pubic lice, proper treatment is needed. Shaving the hair is not effective.

What Are Pubic Lice?

  • Pubic lice are sometimes referred to as ‘crabs’.
  • They are small (about 2 mm long) brown insects that feed on human blood.
  • Despite being called ‘pubic lice’, they can actually live in any coarse human hair such as pubic, underarm, chest and facial hair but they do not live on head hair.
  • Pubic lice lay eggs in the hair which take about 6 days to hatch.
  • They can only move by crawling from one person’s hair to another, they cannot jump.

How Are Pubic Lice Transmitted?

  • Pubic lice are spread by close contact between humans. This does not have to be sexual contact but most commonly involves bodily contact with the affected area.
  • Sometimes pubic lice can be spread by sharing bedding or towels with somebody who is infected, but lice do not survive for very long away from the body.

How Will I Know If I Have Pubic Lice?

  • It is common to have no symptoms of pubic lice until weeks after infestation, or even no symptoms at all.
  • Common symptoms are itching or inflammation in the affected area. Itching may be worst at night.
  • You might also see signs of pubic lice such as:
    • Brown eggs on hair roots.
    • Blue spots and specs of blood on the skin.
    • Dark brown powder in underwear (lice droppings).
  • It is difficult to see the lice themselves although you may see them move.

How Can I Protect Myself?

  • Although using condoms during sex is recommended, this will not stop the spread of pubic lice.
  • The best way to protected yourself is to see a healthcare professional if you think that you or anybody you have been in close personal contact with may have pubic lice.
  • If you are treated for pubic lice then this will prevent you from passing it on to others.

Can I Get a Test for Pubic Lice?

Usually a doctor or nurse will have a close look at the affected area, sometimes with a fine comb and magnifying glass.

  • You should get checked if:
    • A partner or another close contact tells you they have pubic lice.
    • You have any of the symptoms listed above.
  • You can get checked at:
    • A sexual health or genitourinary medicine clinic
    • Some young person’s / contraception clinics
    • GP surgeries

 If you have acquired pubic lice from a sexual contact, it is advisable to get screened for other sexually transmitted infections (STIs).

What Happens If I Have Pubic Lice?

  • The treatment for pubic lice is with permethrin cream or malathion 0.5% solution. You can buy this over the counter from a pharmacy.
  • Your doctor, nurse or pharmacist will tell you how to use the treatment, which is applied to the whole body and washed off after 12 hours.
  • You will need to repeat your treatment after 7 days to ensure it is properly effective.
  • You do not need to shave the hair affected.
  • Machine wash clothing, bedding and towels at 50 degrees or above. Mattresses should be vacuumed.
  • You should tell your partner or any other personal contacts from the last three months who may need treatment even if they don’t have symptoms.
  • You should avoid all close bodily contact including sex (vaginal, anal or oral), until both you and your partner have completed treatment to prevent re-infection.
  • Itching may persist for a few days or weeks even after successful treatment.

What If I Don’t Get Treated for Pubic Lice?

  • Pubic lice will not go away without treatment.
  • If your sexual and household contacts do not receive proper treatment, it is possible for you to get re-infected with lice.


Written by: Dr Alice Llambias-Maw, Dr Nikki Kersey and Dr Paula Briggs
Last updated: January 2021

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