Pubic Lice - STD

Is this your symptom?

  • Pubic lice, a sexually transmitted disease (STD)

Some Basics...

  • Pubic lice are tiny wingless insects that live only on human beings. They are also called "crabs."
  • Pubic lice are very easy to spread to others. They are mainly spread through skin-to-skin contact during sex. If you have pubic lice, there is a 95% chance of spreading them during sex. It is possible that they can be spread through things like infected bed linens or toilet seats. But this is very rare.
  • Pubic lice are annoying but cause no serious health problems.
  • Up to 30% of people with pubic lice also have another sexually transmitted disease (STD).

Symptoms

  • Itching of the pubic area is the main symptom.
  • Pubic hair has gray bugs (lice) 1/16-inch (2 mm) long. They move quickly and are hard to see.
  • Nits (white or tan eggs) stuck to hair shafts near the skin. Unlike dandruff or sand, nits can't be shaken off the hair shafts.

When to Call for Pubic Lice - STD

Call Doctor Now or Go to ER

  • You feel weak or very sick

Call Doctor Within 24 Hours

  • Pubic area looks infected (pus, soft scabs, or open sores)
  • Moving lice in pubic hair and it has been more than 6 hours since treatment
  • Pubic lice or nits come back within 1 month
  • Yellow, green, or gray vaginal discharge
  • White or yellow discharge from penis
  • You think you need to be seen

Call Doctor During Office Hours

  • Pubic lice
  • You have other questions or concerns

Care Advice

Pubic Lice

  1. What You Should Know:
    • Pubic lice are tiny wingless insects that live only on human beings. They are also called "crabs."
    • Pubic lice are annoying but cause no serious health problems.
    • Pubic lice are spread easily. They are spread by skin-to-skin contact during sex. They cannot jump.
    • You can treat pubic lice at home.
    • Here is some care advice that should help.
  2. Treatment - Shampoo Area with Nix: Buy Nix anti-lice creme rinse (permethrin). Follow these instructions:
    • Pour about 2 ounces (60 ml) of the cream onto washed and towel-dried pubic hair. Add a little warm water to work up a lather. Be sure to work the cream into all the hair down to the roots.
    • Leave the Nix on for a full 20 minutes (10 minutes is not long enough to kill all the lice).
    • Rinse the hair and dry it with a towel.
    • Use Nix again in 1 week to kill any nits that were missed.
    • Read all package instructions.
  3. Treatment - Using Other Lice Shampoos:
    • There are other over-the-counter lice shampoos made using pyrethrin. Examples include A-200 Clear, R&C, Pronto, and RID.
    • If this type of shampoo is used, it must be put on dry hair.
    • You should repeat the treatment in 7 days to kill and nits that were missed.
    • Read all package instructions.
  4. Pregnancy and Breastfeeding: The CDC says that women who are pregnant or breastfeeding can be treated with permethrin products (Nix).
  5. Sexual Contacts:
    • Sexual partners that you have had during the last month also need treatment. They still need to be treated even if they don't see any lice.
    • Do not have sex until 2 weeks after treatment. All lice and nits should be gone before you have sex again.
  6. What to Expect:
    • With 2 treatments, all lice and nits should be killed.
    • If they come back, this can mean a few things. It most often means you have had another contact with an infected person. It can also mean the treatment was not left on long enough or repeated.
    • Even after treatment, itching may last for 1 to 2 weeks.
    • There are no lasting problems from having lice. They do not carry other diseases.
  7. Pregnancy Test, When in Doubt:
    • If there is a chance that you might be pregnant, use a urine pregnancy test.
    • You can buy a pregnancy test at the drugstore.
    • It works best first thing in the morning.
    • Follow all package instructions.
  8. Call Your Doctor If:
    • Pregnancy test is positive or you have trouble with the at-home test
    • Moving lice in pubic hair and it has been more than 6 hours since treatment
    • Pubic lice or nits come back within 1 month
    • You think you need to be seen
    • You get worse

How to Remove Dead Lice and Nits

  1. What You Should Know:
    • Only live lice can transmit lice to another person. Nits (lice eggs) do not transmit lice.
    • Most nits (lice eggs) are dead after the first treatment with Nix. The others will be killed with the 2nd treatment in 9 days.
    • Removing the dead nits is not essential. However, it may help with the anti-lice treatment and most people just find the notion of having nits in their hair unpleasant.
  2. Instructions:
    • Remove the dead nits and lice by combing with a special nit comb or pull them out one by one.
    • Repeat this every 2 to 3 days for 3 weeks, until you are sure all of the lice and nits are gone.
    • Wetting the hair with water makes removal easier.
    • Do not use any products that claim they loosen the nits. Here is the reason: they can interfere with the ability of Nix to stay on the hair and keep working.

Hotlines and Internet Resources

  1. United States - STD Hotline:
    • American Social Health Association STD Hotline provides information on STDs, such as chlamydia, gonorrhea, HPV/genital warts, herpes, and HIV/AIDS. It can provide referrals to local clinics.
    • Toll-free number (English): (800) 227-8922
    • Toll-free number (Spanish): (800) 344-7432
    • Their website is at: http://www.ashastd.org
  2. Internet Resources:

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Last Reviewed: 8/20/2017 1:16:11 AM
Last Updated: 5/7/2017 1:36:15 PM

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Pubic Louse

This is an enlargement of a Phthirus pubis, or more commonly known as the pubic or crab louse.

Pubic lice are tiny wingless insects that live only on human beings.

The primary mode of transmission is via the skin-to-skin contact that occurs during sexual intercourse. Lice are very contagious. There is a 95% chance of transmission during a single episode of sexual intercourse. Rarely they may be transmitted via objects such as infected bed linens or toilet seats.

Pubic Lice

The photo shows pubic lice in the pubic hair of groin area. Pubic lice are tiny wingless insects that live only on human beings. The are also called "crabs".

Typical symptoms of pubic lice are:

  • Itching of the pubic area is the main symptom.
  • Pubic hair contains gray bugs (lice) 1/16-inch long, that move quickly, and are difficult to see.
  • Nits (white or tan eggs) cemented to hair shafts near the skin (usually within 1/2 inch or 12 mm). Unlike dandruff or sand, nits can't be shaken off the hair shafts.

Pubic lice are very contagious:

  • The primary mode of transmission is via the skin-to-skin contact that occurs during sexual intercourse. There is a 95% chance of transmission during a single episode of sexual intercourse.
  • Rarely they can be transmitted via objects such as infected bed linens or toilet seats.

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