What are pubic lice?

Pubic lice are tiny insects that live on body hair, usually in the pubic area. They are also called crabs or crab lice. Pubic lice can also be found in chest hair, armpit hair, on the upper thighs, lower abdomen, eyebrows, eyelashes, and facial hair.

How are they spread?

Pubic lice cannot jump or fly. Pubic lice are most often spread through close person-to-person contact, sexual contact, and may also spread by sharing clothing, bedding or towels of someone who has pubic lice. Condoms do not prevent the spread of pubic lice.

Avoid close person-to-person contact with someone who has pubic lice as well as avoid sharing their clothes or towels.

What are the symptoms?

Itching is the most common symptom of pubic lice. If pubic lice get on your eyelashes, the edges of your eyelids may be crusted. You may see lice and their eggs at the base of the eyelashes.

The bites may also become infected, causing irritation and painful swelling. Bites from the lice can cause a rash or small bluish spots on your skin. The spots may last for some time, even after all lice have been treated or killed.

You will also likely see tiny tan-coloured specks on your pubic hair that cannot be pulled off. These specks are the eggs laid by the lice called nits.

What is the treatment?

Pubic lice will not go away without treatment. Treatments for pubic lice include using a special lotion or shampoo to kill the eggs and lice. These can be purchased without a prescription. Follow the directions carefully.

If you have pubic lice on your eyebrows or eyelashes, do not use shampoos or lotions to treat them. Instead, carefully apply occlusive ophthalmic ointment (e.g., Lacri-Lube® or Duolube®) to the eyelid margins (and eyebrows) twice a day for 10 days. This will loosen the lice and nits so that you can remove them with your fingers. Do not use regular petroleum jelly (e.g. Vaseline®) as it can irritate the eyes. For more information about treatment, speak with your health care provider.

Your sexual partner will need to be treated as well. Other people living in your home do not need treatment unless they have shared your clothes, bed or towels.

Contact a health care provider if the lice do not go away after the first treatment, or if you have any signs of a skin infection. Skin infections can be caused by frequent scratching.

What should I do with my clothes, bed sheets, and towels?

All clothes, bed sheets, towels and cloth toys that may have come into contact with pubic lice need to be washed with hot water or dry-cleaned. Use an automatic washing machine with water that is warmer than 50°C (122°F), or place items in a hot dryer for 30 minutes.

Anything that cannot be washed in hot water or dry-cleaned should be put in a sealed airtight plastic bag for 7 days to kill the lice.

How can I reduce my chance of getting a sexually transmitted infection (STI)?

Practice safer sex by using a condom

When used correctly, male and female condoms help prevent the spread of many STIs during vaginal, anal and oral sex. Condoms are less effective at protecting against STIs transmitted by skin-to-skin contact, such as herpes simplex, genital warts (human papillomavirus (HPV)), and syphilis (when sores are present).

Important things to remember when using condoms:

• Check the condom package for damage. Do not use a condom that has been damaged.
• Check the expiry date. Do not use a condom that is outdated.
• Carefully open the package so that the condom does not tear. Do not use a condom that has been torn.
• Keep condoms away from sharp objects such as rings, studs, or piercings.
• Store condoms at room temperature.
• A new condom should be used every time you have sex. Do not reuse condoms.
• Do not use 2 condoms at once.
• Use only water-based lubricants with male latex condoms. Oil-based lubricants, such as petroleum jelly, lotion, or baby oil can weaken and destroy latex.
• Water or oil-based lubricant may be used with polyurethane condoms.
• Use only condoms that are made of latex or polyurethane (plastic). Latex condoms and polyurethane condoms are the best types of condoms to use to help prevent pregnancy and STIs. (Animal skin condoms can help prevent pregnancy but don’t work as well as latex or polyurethane condoms to prevent STIs.)

Get vaccinated

Some STIs, such as hepatitis A, B and human papillomavirus (HPV) can be prevented with vaccines. Talk to your health care provider about how to get these vaccinations.

Know your sexual health status

If you have recently changed sexual partners, or have multiple sex partners, getting regularly tested for STIs will tell you if you have an infection. Some people can have an STI and not have any symptoms. Finding and treating an STI reduces the chances of passing infections on to your partner(s).

The more partners you have, the more likely you are to be exposed to STIs.

Talk about prevention

Talk to your partner(s) about STIs and how you would like to prevent them before having sex. If you are having trouble discussing safer sex with your partner(s), talk about it with your health care provider or a counselor.

For tips on how to talk to your partner(s), visit the BC Centre for Disease Control (BCCDC) Smart Sex Resource https://smartsexresource.com/sex-talk/talk-about-it

Informing partners

If you have a sexually transmitted infection and are sexually active, it is important to tell your sexual partner(s). This will enable them to make decisions about their health and getting tested.

For more information

For more information on how you can reduce your chance of getting an STI, see HealthLinkBC File #08o Preventing sexually transmitted infections (STIs).