Oh crab! – Let’s talk about pubic lice



If you have pubic lice (or genital crabs), don’t feel alarmed or ashamed. Many people get crabs and while they can be annoying and cause discomfort, it’s easy to treat them.

What are pubic lice (crabs)?

Pubic lice are tiny insects (2mm long) and grey-brown in colour. They can be hard to spot, but sometimes you may be able to see them in your hair. They most often live on pubic hair around the penis or vagina but can also be found in hair on the chest, armpits, face, and eyelashes. They do not affect hair on the head.

What are the symptoms of pubic lice?

  • Intense itching, which is usually worse at night
  • Small red or blue spots on your skin (lice bites)
  • White/yellow dots attached to your hair (lice eggs)
  • Dark red or brown spots in your underwear (lice poop)
  • Crusted or sticky eyelashes, if eyelashes are affected

How do you get crabs?

You can get genital crabs through close contact with another person, such as during sex.

Are pubic lice an STI?

Pubic lice often get lumped in with sexually transmitted infections (STIs). That’s because people get pubic lice most often during sex. But pubic lice aren’t an actual disease or infection.

How do you treat pubic lice?

Crabs can cause intense itching but are treatable. Pubic lice treatment usually involves special shampoos or creams to kill the lice.

Who is most at risk of pubic lice?

Pubic lice are usually spread through sexual contact and are most common in sexually active teens and people in their 20s. Having multiple sexual partners increases the chances of getting crabs. It’s important to note that people who have other sexually transmitted infections are at higher risk for pubic lice.

Does PrEP or condoms protect against crabs?

PrEP or condoms do not protect against pubic lice.

Should my sex partner(s) get treated for crabs?

Get in touch with your sexual partner(s) from the previous two months. They may have pubic lice too and will need treatment.

Does shaving get rid of crabs?

No, shaving your pubic area with a razor isn’t a treatment to get rid of crabs.

Does rubbing alcohol kill pubic lice?

You shouldn’t attempt to use rubbing alcohol to kill pubic lice. This may be effective in adult lice, but it’s not effective against nits or eggs. You should only use the medications your healthcare provider recommends.

How can I prevent genital crabs?

The only way to prevent pubic lice is to avoid any close physical contact with people who have it. Still, you can take reasonable steps to lower your risk for crabs and prevent them from coming back:


  • Avoid sharing personal items like clothes or towels.
  • Use pubic lice treatment which usually involves special creams or shampoos to kill the lice. After treatment, make sure to comb any nits (eggs) out of your hair.
  • Make sure your partner(s) get treated if you had pubic lice.
  • Wash clothing, bedding, and towels in hot water.
  • Finish treatment and check that the crabs are gone before resuming sex.


  • Have sex or close physical contact with someone who has pubic lice.
  • Share clothing, bedding, or towels with a person who has pubic lice.
  • Use insecticide sprays. They don’t control pubic lice and can be harmful to you.
  • Try on bathing suits when shopping. If you do try them on, wear underwear.

Can I use pubic lice shampoo preventively?

Perhaps you found out that a sexual partner from the past month has pubic lice. It’s fine to use one of the lice shampoos or creams before you have symptoms to be safe.

Will frequent showers prevent pubic lice?

Getting pubic lice has nothing to do with your hygiene. You get pubic lice by having close physical contact with a person who has them.

Are pubic lice dangerous?

No, pubic lice won’t cause serious health concerns. Usually, the main problems that the lice cause are itching and discomfort. You may get a bacterial infection if you end up scratching your skin a lot.

How long does it take to get rid of pubic lice?

Most treatments take about two weeks. If the lice don’t go away completely, you may need to repeat treatment.

Can I get pubic lice more than once?

Yes, you can get pubic lice again. Take steps to prevent pubic lice so you don’t get them again.

When can I resume sex?

Pause your sex life until both you and your partner(s) have finished treatment. Check that the lice haven’t returned. This could take about two weeks.

When should I see a healthcare provider?

In most cases, over-the-counter treatment from your pharmacy is effective in killing the lice. If this doesn’t work, contact a healthcare provider who may need to prescribe a stronger medication.


Article courtesy of Engage Men’s Health which offers free and friendly sexual health services to gay, bi and other men who have sex with men in Johannesburg, Nelson Mandela Bay and Buffalo City. Services include HIV testing, treatment of HIV and other STIs, PrEP, PEP, and HIV self-testing kits. For more information or to book an appointment call/WhatsApp 082 607 1686 or visit their website.

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