Pubic lice/crabs... get them off me!

(1) Dear Alice,

I have recently discovered that I have what appear to be crabs in my pubic hair. They are itchy and annoying and appear to be laying eggs. How do I get rid of them?


(2) Dear Alice,

I think I have pubic lice, a.k.a. "crabs." Do I need to see a doctor about this problem, or is there over-the-counter medication of some kind I can use to expel the little buggers from their new home? Also, I'm curious as to how I got them since I haven't had sex for several months and this is a recent development. Can one contract this problem from sharing clothing, towels, or bedclothes?

Thanks Alice,
Itching to Know

Dear Reader and Itching to Know,

One in this predicament might ask, "to scratch or not to scratch?" To which oneself might reply, "Who cares?! Just get these things off me!" Fortunately, pubic lice tend to be little more than itchy and annoying. They are not carriers of infection, sexually transmitted, or otherwise. Most often spread by sexual contact, pubic lice can be transmitted via close body contact, clothes, bedding, and furniture. These critters, known scientifically as phthirus pubis, are tiny, wingless insects that nest in pubic hair and dine on blood. Their crab-like claws, which they use to hold on tight to hair, earned them their popular nickname, "crabs." Each louse (singular for lice) is just two millimeters at its biggest, and lice eggs (nits) are pale and even smaller. Eggs only take eight days to hatch — which is one reason why they can spread so quickly. A particularly hairy person might also discover lice around her/his anus, legs, chest, and even facial hair (though crabs tend to prefer the warm dark areas).

Successful treatment includes using lice-killing lotion containing one percent permethrin or a mousse containing pyrethrins and piperonyl butoxide (available over-the-counter at drug stores) on affected areas of the body, and washing clothes and bedding in hot water that is at least 130 degrees Fahrenheit and drying in the hot dryer cycle. Most products recommend a repeat treatment in seven days to ensure any eggs that hatched since the first treatment will be destroyed. You may want to consider selecting a product that is labeled for killing both lice and eggs. If you have sexual partner(s), it’s recommended that they also de-louse. Finally, it's not a bad idea to refrain from sexual activity or sharing clothes, towels, etc. until treatment is complete. The good news is that treatment usually works quickly. If this approach does not solve the problem for you and your partner(s), consider contacting a health care provider for additional advice.

Current research suggests that the popularity of shaving pubic hair may be connected to the recent decline of pubic lice rates since without pubic hair present it’s difficult to establish an infestation. However, shaving or removing the hair down there isn’t considered an effective method of treatment for pubic lice.

A person might get itchy just thinking about these little buggers; keep in mind that pubic lice are nothing to lose sleep over (at least not once you've sent them packing!) and effective treatment is available from your nearest drug store.

Best of luck with treatment,

Last updated Dec 18, 2015
Originally published May 03, 1996

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