Pubic lice

Pubic lice (often called "crabs") are tiny insects that live on coarse body hair — mainly pubic hair, but sometimes also armpit hair, chest hair, or facial hair. They feed on blood and cause itching. They're passed on through close body contact, usually during sex, and they're easily treatable with a special lotion or cream from a pharmacy.

• Pubic lice are tiny parasitic insects that live on coarse body hair.
• They're usually spread through close physical contact, especially during sex.
• The main symptom is itching in the affected area.
• They're treated with an insecticide lotion or cream, available from pharmacies without a prescription.
• They're not the same as head lice — different species, different habitat.

What they are

Pubic lice (Pthirus pubis) are very small — about 2mm long, roughly the size of a pinhead. They're greyish-brown and have crab-like claws (which is where the nickname "crabs" comes from) that grip onto coarse hair. They can't jump or fly — they crawl from one person to another through direct contact.

They live on the hair, lay eggs (called nits) at the base of the hair shaft, and feed on small amounts of blood from the skin. It's the biting and feeding that causes the itching.

How you get them

Pubic lice are mainly spread through close body-to-body contact — usually sexual contact where pubic areas are pressed together. They can also occasionally be spread through sharing towels, bedding, or clothing, though this is less common because they can't survive long away from the body.

Condoms don't prevent pubic lice — they're spread through skin and hair contact, not through bodily fluids.

You can't get them from toilet seats, swimming pools, or casual contact like hugging.

Symptoms

The main symptom is itching in the pubic area — often quite intense, especially at night. You might also notice:

• Small blue-grey spots on the skin (from lice bites)
• Tiny white dots attached to the base of hairs (these are nits — the eggs)
• Brown specks in your underwear (lice droppings)
• The lice themselves, though they're small and hard to spot

Symptoms can take a few weeks to develop after you first catch them, so you might not realise straight away.

Treatment

Treatment is straightforward and available over the counter at pharmacies — you don't need a prescription or a doctor's appointment. The most common treatment is a lotion or cream containing permethrin or malathion. [CHECK: current recommended first-line treatment]

You apply it to all affected areas (and any other area with coarse body hair — armpits, chest, etc.), leave it on for the recommended time, then wash it off. You usually need to repeat the treatment after 7 days to kill any lice that have hatched from remaining eggs.

You should also wash bedding, towels, and clothing on a hot cycle, and let any recent sexual partners know so they can get treated too.

Things people get wrong

"Pubic lice mean you're dirty." They're not about hygiene. Lice don't care how clean you are — they feed on blood, not dirt. Anyone who has close physical contact with someone who has them can catch them.

"Shaving your pubic hair prevents them." Shaving removes the hair they live on, so it can help get rid of them — but it's not a prevention method, and the treatment lotion is easier and more effective.

"They're really rare now." Pubic lice have become less common in recent decades, possibly linked to the trend for pubic hair removal. But they still exist and still get passed around. [CHECK: current UK prevalence trends]

Things people ask about pubic lice

Can I treat them myself?

Yes. Buy the treatment from a pharmacy — you don't need to see a doctor. The pharmacist can advise you on which product to use. If the first treatment doesn't work, then see a GP or sexual health clinic.

Do I need to tell my partner?

Yes. Anyone you've had close physical contact with recently needs to know so they can check and get treated if needed. Otherwise you'll just pass them back and forth.

Are pubic lice an STI?

They're usually grouped with STIs because they're most commonly passed on through sexual contact, but they're parasites rather than an infection. They don't cause any long-term health problems — just itching and irritation until they're treated.

Can they spread to my head?

Pubic lice are a different species from head lice. They prefer coarse body hair and don't typically live on the scalp. Head lice, on the other hand, live on the head and don't usually live in pubic hair. Different bugs, different territories.

Where to get help

• Your pharmacist — for over-the-counter treatment, no appointment needed.
• Sexual health clinics — can diagnose and treat, free and confidential.
• Your GP — if pharmacy treatment hasn't worked.

Pubic lice are very tiny insects, about the size of a pinhead. They live on the thicker hair on your body, especially the hair between your legs. They're sometimes called "crabs" because of their shape. They bite the skin and feed on small amounts of blood, which causes itching.

You catch them through close body-to-body contact, usually during sex. They crawl from one person to another. They can't jump or fly. You can't catch them from toilet seats or swimming pools.

Condoms don't stop them because they spread through hair and skin contact, not through body fluids.

The main sign is itching between your legs, especially at night. You might also see tiny white dots attached to hairs (these are the eggs) or notice small brown specks in your underwear.

Treatment is simple. You buy a special cream or lotion from a pharmacy — you don't need to see a doctor. You put it on, leave it for a set time, wash it off, and repeat after a week. You should also wash your bedding and towels on a hot wash.

Getting pubic lice doesn't mean you're dirty. They don't care about hygiene. Anyone can catch them through close contact.

If you get them, you need to let recent sexual partners know so they can get treated too.