What are pubic lice?

Pubic lice (also known as crabs or Pthirus pubis) are tiny insects that live in coarse body hair. Pubic lice may be found in:

• pubic hair
• armpit hair
• beards
• chest hair
• eyelashes
• eyebrows

They do not live on the scalp.

The lice lay eggs (also known as nits) that are glued to the base of your hair near your skin. Pubic lice hatch after 6 to 10 days, leaving behind empty egg sacs.

Adult pubic lice are the colour grey and smaller than head lice. They are a sexually transmitted infection (STI).

How are pubic lice spread?

Pubic lice are most commonly spread through skin-to-skin sexual contact.

You can also catch pubic lice by having close, non-sexual contact with someone who has lice such as kissing someone with an infested beard or moustache, sleeping in the same bed or sharing towels or clothing.

Pubic lice only infect humans, so you cannot catch them from pets or other animals.

What are the symptoms of pubic lice?

If you have pubic lice, you may notice:

• itching around your genitals or back passage (anus), especially at night when the lice are most active
• tiny blue spots around your genitals
• spots of blood or fine, gritty (sandy) debris in your underwear
• visible lice or tiny eggs in your pubic hair

Pubic lice feed on human blood. Their saliva (spit) often irritates the skin, causing intense itching.

Pubic lice do not burrow under the skin.

When should I see my doctor?

You should visit your doctor or sexual health clinic if:

• you think you may have pubic lice
• you have had sexual contact with someone who has pubic lice
• you have developed a skin infection from scratching the infested area

How are pubic lice diagnosed?

Your doctor can diagnose pubic lice by carefully examining affected areas and finding lice, eggs or empty sacs. Dark specks of louse droppings (poo) or blue discolouration on your torso or thighs can help make the diagnosis.

Your doctor may apply a piece of tape to the infected area to pick up lice to examine them under a microscope.

If you are diagnosed with pubic lice, it is a good idea to also be tested for other STIs.

How are pubic lice treated?

Pubic lice can be treated with creams or lotions available over-the-counter from a pharmacy.

You should examine your whole body for lice or ask someone else to help you check.

Treatment does not kill unhatched eggs, so you will need to repeat the treatment 1 to 2 weeks later to treat any new lice.

If treatment with a cream or lotion is not successful, there are other prescription-only treatment options including a tablet.

If you have pubic lice on your eyelashes, you will need special prescription-only soft white paraffin lotion or petroleum jelly. It is usually applied twice a day for 8 to 10 days. You may also need to see an ophthalmologist (eye specialist).

Antihistamines can help with itchiness, which may also last a few days after treatment.

You do not need to shave your pubic hair or remove eggs (nits), but it may help.

In addition to treating pubic lice with a cream or lotion, you should:

• Inform any sexual contacts from within the last month, so they can be checked and treated.
• Avoid sexual contact for 7 days after treatment or until your symptoms have gone away, whichever is later.
• Thoroughly wash all your bed linens and underwear on a hot cycle (60℃) and then dry them all in the dryer. If you have some items that cannot be washed, you can dry clean them or put them in a sealed plastic bag for 14 days so any lice will die.

Current sexual partners and household members should be examined and then treated at the same time as you if necessary.

What are the complications of pubic lice?

Complications of pubic lice are generally uncommon and rarely serious, but may include:

• secondary bacterial skin infections from scratching broken skin
• sores and crusting that get worse with repeated irritation
• eye complications when lice infest eyelashes or eyebrows, which can lead to inflammation, scarring, loss of eyelashes and impacts on vision
• skin changes such as thickening or discoloration from chronic infestation

Can pubic lice spread infectious diseases?

Pubic lice are not known to transmit any infectious diseases.

How can the spread of pubic lice be prevented?

Here are some tips on how you can reduce the risk of spreading pubic lice:

• Do not share your bedding, towels or clothing until you have finished your treatment.
• Avoid sexual contact until treatment has worked and you are free of lice.
• Ensure that your sexual partner(s) have been informed and treated, otherwise they may reinfest you or infest others.

It is important to remember that condoms do not provide protection against pubic lice.

Pubic lice can survive less than 24 hours if they are not on a human, so it is not necessary to treat carpets or spray insecticide in a room.

Resources and support

• Read more about pubic lice on the Stay STI Free pubic lice webpage.
• If you are worried about telling a partner about a diagnosis, the Let Them Know website helps you send free, anonymous text messages or emails to let them know to get tested.
• Learn more about safe sex at ReachOut Australia's guide for safe sex.
• Make STI testing your Beforeplay — learn why it is important to get tested for STIs and where you can do it at the Australian Government, Department of Health, Disability and Ageing website.

Languages other than English

• StaySTIFree has fact sheets about STIs in many community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

• Better to Know is a sexual health site for Aboriginal and/or Torres Strait Islander peoples with many resources like fact sheets, videos, and clinic directories.