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Pubic lice or crabs

Pubic lice (often called "crabs") are parasites that live on body hair, usually in the genital area. Occasionally they are found on hair on the legs, armpits, mustache, beard, eyebrows, or eyelashes. Pubic lice can be treated with a special shampoo.

Causes

You get pubic lice though close person-to-person contact, including sexual contact. Pubic lice are also spread by sharing bedding, clothing or towels. If you have pubic lice, you can pass it to others even if you don’t have symptoms.

Symptoms

The most common symptom of pubic lice is itchiness. Bites can cause a rash or small bluish spots on your skin. The spots may last for several months, even after all lice are gone.  You can also see tiny tan-coloured specks on your pubic hair, very close to the skin, that cannot be easily pulled off. These specks are the eggs (nits), which are laid by adult lice.

Tests and Diagnosis

Testing is done with an exam.  Your health care provider will look for the adult lice and nits. Pubic lice are typically 1 mm in length. It can be easier to see the nits on the hair than it is to see the lice.

Treatment

Pubic lice are treated by using a special shampoo that you can buy without a prescription. A pharmacist or health care provider can give you information about how to use the shampoo.

All clothes and bed sheets need to be washed with hot water (50 degrees Celsius) or dry-cleaned. Anything that cannot be washed in hot water or dry-cleaned should be put in a sealed airtight plastic bag for one week. Mattresses should be vacuumed.

Sexual Partners

Your partners should also be treated for pubic lice. Other people living in your house do not need to be treated unless they have shared your bed, clothes or towels.

Complications

Pubic lice don’t usually cause any other health problems.  Excessive scratching can lead to skin infections. See a health care provider if this happens.

Prevention

It is a good idea to be tested regularly for STIs, especially if you have new sexual partners or open relationships.  Talking with partners about safer sex makes sure everyone knows what to expect. Condoms are great if they work for you but they will not stop the spread of pubic lice.

Resources

HealthLink BC – Information about pubic lice in multiple languages
SmartSexResource – If you are worried or have anxiety about pubic lice
Trans Care BC – Gender-affirming sexual and reproductive health information

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