A pubic louse "Crabs" or pubic lice are small insects which live in the pubic hair. They are very easy to catch via sexual contact with an infected person. Occasionally pubic lice may be spread by close personal contact or contact with articles such as clothing, bed linens, and towels that have been used by an infested person.


Steps
Diagnosis

1. Know what crabs are: Pubic lice are 1.1-1.8 mm in length. Under a microscope they look crab-like and appear very different from head and body lice.
2. Diagnosis yourself:
   • Pubic lice infestation is diagnosed by finding a “crab” louse or eggs on hair in the pubic region or, less commonly, elsewhere on the body (eyebrows, eyelashes, beard, mustache, armpit, perianal area, groin, trunk, scalp). Although pubic lice and nits can be large enough to be seen with the naked eye, a magnifying lens may be necessary to find lice or eggs.
   • A typical symptom is itching in the genitals.
   • Symptoms will typically appear 5-14 days after sexual contact with an infected person.

Treatment

1. Buy an over the counter licek killing lotion at a drug store:
   • Recommended non perscription option: A lice-killing lotion containing 1% permethrin or a mousse containing pyrethrins and piperonyl butoxide can be used to treat pubic (“crab”) lice. These medications are safe and effective when used exactly according to the instructions in the package or on the label.
   • Lindane shampoo is a prescription medication that can kill lice and lice eggs. However, lindane is not recommended as a first-line therapy. Lindane can be toxic to the brain and other parts of the nervous system; its use should be restricted to patients who have failed treatment with or cannot tolerate other medications that pose less risk. Lindane should not be used to treat premature infants, persons with a seizure disorder, women who are pregnant or breast-feeding, persons who have very irritated skin or sores where the lindane will be applied, infants, children, the elderly, and persons who weigh less than 110 pounds.
2. Wash the infested area; towel dry.
3. Carefully follow the instructions in the package or on the label. Thoroughly saturate the pubic hair and other infested areas with lice medication. Leave medication on hair for the time recommended in the instructions. After waiting the recommended time, remove the medication by following carefully the instructions on the label or in the box.
4. Following treatment, most nits will still be attached to hair shafts. Nits may be removed with fingernails or by using a fine-toothed comb.
5. Put on clean underwear and clothing after treatment.
6. Remove lice from dirty clothes.
   • To kill any lice or nits remaining on clothing, towels, or bedding, machine-wash and machine-dry those items that the infested person used during the 2-3 days before treatment. Use hot water (at least 130°F) and the hot dryer cycle.
   • Items that cannot be laundered can be dry-cleaned or stored in a sealed plastic bag for 2 weeks.
7. Contact past sex partners. All sex partners from within the previous month should be informed that they are at risk for infestation and should be treated.
8. Avoid sex. Persons should avoid sexual contact with their sex partner(s) until both they and their partners have been successfully treated and reevaluated to rule out persistent infestation.
9. Repeat treatment in 9-10 days if live lice are still found.
10. Go to a doctor and ask for an evaluation for other sexually transmitted diseases (STDs).

Special Treatment for Eyebrows and Eyelashes

1. If only a few live lice and nits are present, it may be possible to remove these with fingernails or a nit comb.
2. If additional treatment is needed for lice or nits on the eyelashes, careful application of ophthalmic-grade petrolatum ointment (only available by prescription) to the eyelid margins 2-4 times a day for 10 days is effective. Regular Vaseline* should not be used because it can irritate the eyes if applied.

Tips

• Dogs, cats, and other pets do not play a role in the transmission of human lice.

Warnings

• Persons infested with pubic lice should be evaluated for other sexually transmitted diseases (STDs).
• Pubic lice found on the head or eyelashes of children may be an indication of sexual exposure or abuse.
• Using a condom does not protect a person from contracting crabs.