Pubic Lice: Care Instructions

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Pubic lice near pubic area, with close-up of louse and eggs (nits)

Your Care Instructions

Pubic lice are tiny bugs that usually live in your pubic area. Sometimes they're also found on facial hair, eyelashes, eyebrows, armpits, chest hair, and the scalp.

They're different than the kind of lice that you can get on your head or body. Pubic lice are also called "crabs" because they look like tiny crabs. Millions of people get pubic lice every year. It doesn't mean you're not clean.

Lice eggs (nits) are often easier to see than live lice. They look like tiny yellow or white dots attached to the pubic hair, close to the skin. Nits can look like dandruff. But you can't pick them off with your fingernail or brush them away.

Pubic lice are very contagious. That means they can easily spread from one person to another. Pubic lice are usually spread through sexual contact. But sometimes they can spread through shared clothes, bedding, or towels. It's rare to get pubic lice from a toilet seat or other smooth surface. That's because lice can't live away from a human body for very long.

Pubic lice can be uncomfortable and inconvenient, but they're not dangerous. They may cause itching and marks around the pubic area or other areas where they are found.

You can learn how to treat them at home. You can treat lice and their eggs with prescription or over-the-counter medicines. After treatment, your skin may still itch for a week or more. This is because of your body's reaction to the lice.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Use the medicine, body lotion, or shampoo that your doctor recommends. Use the treatment exactly as directed. Some medicines need just one treatment. Others require follow-up treatments.
  • Check your pubic area for live lice 48 hours after treatment. If you find some, try a different type of treatment. It may be that the lice in your area are resistant to the first treatment you tried.
  • Check the area again 7 to 10 days after the first treatment. If you find live lice, you may need a second treatment. This is to make sure all lice are killed, including those that hatched since the first treatment.
  • Try not to scratch. Use an over-the-counter cream or calamine lotion to calm the itching. If itching affects your sleep, ask your doctor if you can take an antihistamine that might reduce itching and make you sleepy, such as diphenhydramine (Benadryl). Be safe with medicines. Read and follow all instructions on the label.
  • You may want to remove nits after treatment, but you don't have to remove them all. Some people use a special comb to remove nits after using lice medicine. The combs are often packaged with over-the-counter lice shampoos. A flea comb that's made for dogs and cats will also work.
  • Take steps to avoid spreading lice.
    • Machine-wash bedding, towels, and clothes in hot water (at least 130°F). Dry them in a hot dryer. If you don't have access to a washing machine, instead you can store these items in a sealed plastic bag for 14 days.
    • Vacuum carpets, mattresses, couches, and other fabric-covered furniture. You don't have to do other special deep cleaning.
    • Avoid sexual contact until you've successfully treated the lice. Tell all your sex partners from the last month that you have pubic lice. Talking about this may be uncomfortable. But it will help prevent you from spreading the lice back and forth.

When should you call for help?

Call your doctor now or seek immediate medical care if:

  • You have signs of a skin infection, such as:
    • Increased pain, swelling, warmth, and redness.
    • Red streaks coming from an area of your skin.
    • Pus draining from an area of your skin.
    • A fever.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You see live lice or new nits after you have followed the directions for your medicine.
  • Anyone else in your family has lice.
  • You do not get better as expected.

Where can you learn more?

Go to

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.