Pubic lice, also known as crabs, are tiny parasitic insects that infest the coarse hair of the human body, particularly in the pubic area. While they are commonly spread through sexual contact, they can also be transmitted via contaminated bedding, towels, or clothing. If you suspect you might have pubic lice, here’s what you need to know to identify and address the issue.
Prevalence of Pubic Lice by Age Group
This chart displays the prevalence of pubic lice cases per 100,000 people across different age groups, showing the highest occurrence in the 25-34 age range.
Common Symptoms of Pubic Lice
1. Intense Itching
One of the earliest and most common symptoms is persistent itching in the pubic area. This occurs due to the lice biting and feeding on blood, triggering an allergic reaction in the skin. Some individuals report that the itching is worse at night and can become unbearable if untreated.
Case Study:
A 28-year-old male from Chicago noticed an unusual, persistent itch in his pubic region. Initially dismissing it as a skin irritation, he later discovered tiny dark specks in his underwear. Upon visiting a dermatologist, he was diagnosed with pubic lice and successfully treated with a medicated lotion.
2. Visible Lice or Eggs (Nits)
- Adult lice are tiny (about 1-2 mm long), tan or grayish-white, and can sometimes be seen moving in pubic hair.
- Nits (lice eggs) are oval, white, and firmly attached to the base of hair shafts.
- A magnifying glass may be needed to spot them clearly.
Case Study:
A 35-year-old woman from Los Angeles noticed small white specks in her pubic hair that wouldn’t wash away. Upon closer inspection, she realized they were nits attached to her hair shafts. A medical examination confirmed a lice infestation, and she underwent successful treatment with a prescription lotion.
3. Bluish Spots or Red Bumps
Lice bites can cause small blue or purplish spots on the skin due to minor bleeding under the skin. Additionally, some individuals develop red bumps or sores from scratching.
4. Dark or Powdery Debris in Underwear
Lice droppings appear as fine black or brown specks in underwear or sheets, signaling an active infestation.
Case Study:
A 40-year-old man from New York found tiny black specks in his underwear for several days. Initially assuming it was dirt, he later experienced intense itching and sought medical attention. A doctor confirmed pubic lice, and he was prescribed a topical treatment that resolved the issue.
5. Irritation Beyond the Pubic Area
Although pubic lice primarily inhabit the genital region, they can spread to other coarse hair areas such as:
- Armpits
- Chest and abdomen
- Eyelashes and eyebrows (less common)
Time Taken for Symptoms to Appear After Exposure
| Time Frame | Percentage (%) |
|---|---|
| 1-3 days | 10% |
| 4-7 days | 35% |
| 8-14 days | 45% |
| 15+ days | 10% |
This chart shows the distribution of time taken for symptoms to appear after exposure, with the majority of cases occurring between 8-14 days.
How To Confirm a Pubic Lice Infestation
If you suspect you have pubic lice, follow these steps for confirmation:
- Perform a Close Self-Examination
- Use a bright light and a magnifying mirror to inspect the affected area.
- Look for small moving lice and oval nits attached to hair shafts.
- Check for signs of irritation, redness, or small blue spots that may indicate lice bites.
- Run a fine-toothed comb through the hair to help identify any lice or eggs that may not be immediately visible.
- If necessary, take clear photos and compare them with online medical references to confirm the presence of lice.
- Check for Symptoms on Your Spouse
- Since pubic lice are highly contagious, it’s essential to check if your husband or wife has similar symptoms.
- Have your spouse inspect their pubic region for signs of lice or nits, especially if they have experienced unusual itching or irritation.
- Look for any secondary infections from excessive scratching, such as open sores or pus-filled bumps.
- Encourage your spouse to seek treatment at the same time to prevent reinfestation.
- Visit a Healthcare Provider
- A doctor can diagnose pubic lice through a physical examination.
- If symptoms persist despite initial treatment, your doctor may recommend a stronger medication or an alternative treatment approach.
- In cases involving eyelashes or eyebrows, special treatments may be needed to avoid eye irritation.
- A medical professional may also provide guidance on how to prevent reinfestation and the best hygiene practices to follow.
- If other sexually transmitted infections (STIs) are a concern, the healthcare provider may recommend additional testing to rule out any related health issues.
Most Affected Body Areas by Pubic Lice
| Body Area | Prevalence (%) |
|---|---|
| Pubic region | 95% |
| Armpits | 30% |
| Chest/abdomen | 15% |
| Eyelashes/eyebrows | 5% |
This chart illustrates the most commonly affected body areas by pubic lice, highlighting the pubic region as the most prevalent site of infestation.
Treatment and Prevention
Treatment Options
Over-the-Counter Lice Treatments
- Procedure: Apply permethrin or pyrethrin-based creams or shampoos to the affected area, leaving it on for the recommended time before rinsing off.
- Cost: $10-$30 per treatment.
- Effectiveness: 90% success rate with proper application; may require a second treatment after 7-10 days.
Prescription Medications
- Procedure: A doctor may prescribe stronger topical lotions (e.g., malathion or ivermectin) or oral medication in resistant cases.
- Cost: $50-$100 per prescription.
- Effectiveness: Over 95% success rate, particularly for resistant lice infestations.
Cleaning Personal Items
- Procedure: Wash all clothing, bedding, and towels in hot water (at least 130°F/54°C) and dry on high heat; vacuum upholstery and carpets.
- Cost: Minimal (cost of detergent and electricity).
- Effectiveness: Highly effective in preventing reinfestation, as lice cannot survive more than 48 hours off the body.
Avoid Close Contact
- Procedure: Refrain from sexual activity and avoid sharing personal items until treatment is complete.
- Cost: No cost.
- Effectiveness: Crucial for preventing reinfection; highly effective when combined with treatment.
Prevention Tips
- Avoid sharing personal items like towels, underwear, and razors, as lice can cling to these objects and transfer easily.
- Regularly wash and change bedding and clothing, using hot water (at least 130°F/54°C) and a high-temperature drying cycle to kill any remaining lice or eggs.
- Perform self-checks frequently, especially if you’ve been in close contact with someone diagnosed with pubic lice, and use a fine-toothed lice comb to examine the hair for any signs of infestation.
- Vacuum carpets, upholstery, and car seats to ensure no lice remain in fabric surfaces.
- Store potentially contaminated items in sealed plastic bags for at least two weeks to starve any surviving lice.
Editorial Advice
If you’re dealing with persistent itching or unexplained irritation in the pubic region, it’s crucial not to ignore it. Prompt identification and treatment of pubic lice prevent further complications and transmission to others. Reyus Mammadli, health care advisor, recommends seeking medical attention if over-the-counter treatments don’t work within a week. Also, addressing the issue with your husband or wife is key to stopping the cycle of reinfestation.
