Updated August 2025
Pubic lice, also sometimes called crabs, are small grey or brownish-red insects that live mostly in pubic hair. Sometimes they can be found in eyelashes, eyebrows, chest, armpit and facial hair and are usually spread through sexual contact.
Symptoms might appear right away but if it is a mild case a person might not notice symptoms for a few weeks. The most common symptom is itching in the pubic area. Scratching can lead to sores and a possible bacterial infection of the skin. Some people might notice blue spots in the pubic area or on the inner thighs where the lice bite. Dried spots of blood might also be found on a person’s underwear, along with small black spots of lice poo. Live lice or lice eggs (“nits”) could also be seen.
A health care provider can inspect the area for lice and nits. They can be seen with the naked eye or sometimes a magnifying glass is necessary.
A person diagnosed with pubic lice should consider testing for sexually transmitted infections (STIs).
Scratching and irritation of the skin can lead to bacterial infections.
Anyone can get pubic lice, though it is most common among sexually active people and in situations where individuals are in close contact.
Pubic lice will not go away without treatment. Ordinary soap and water will not kill them. Pharmacies have over the counter cream and shampoo treatments. Following treatment, the pubic lice will usually be killed but may leave some nits attached to your hair. Nits should be physically removed by using a fine-toothed comb or with your fingernails. Shaving alone might not get rid of the problem. Treatment should be repeated if live lice are found 9 to 10 days later.
Clothes, bedding, and other possible contaminated items should be washed in hot water and dried at the hottest setting, dry cleaned, or put into plastic bags and sealed for two weeks. Items that cannot be washed or bagged, such as sofas, mattresses and rugs should be thoroughly vacuumed.
To prevent pubic lice, avoid having sexual contact or sharing bedding or clothing with anyone who has an infestation. If you are being treated for pubic lice, your sexual partner(s) must also be treated.
To reduce your risk of getting an STI use a condom correctly every time you have vaginal, anal, and oral sex or share sex toys.
Here are a few important points to remember:
Pubic lice are usually spread through sexual contact. Sometimes they can also be spread by close personal contact or contact with infested personal items such as clothing, towels, and bed linens. It is very rare for pubic lice to be spread by contact with a toilet seat since they can only live for 1 to 2 days off of the human body.
Anyone can get pubic lice. Pubic lice are not related to poor hygiene or social status.
Animals cannot get or spread pubic lice.
It is important for sexual partners and people who live in the same home to check for pubic lice. If they have pubic lice, they will need to be treated at the same time so that they will not re-infect you after you have completed the treatment.
Do not have sex again if you or your partner(s) have not completed treatment or if you are still displaying symptoms of the infection. Remember, you can become re-infected immediately after your infection clears up.
Ask your health care provider when receiving treatment about when you can have sex again.
Call the Sexual Health Infoline Ontario at 416-392-2437 (1-800-668-2437) or visit toronto.ca/health
Safer sex: To reduce your risk of getting a sexually transmitted infection (STI), use a condom every time you have vaginal, anal or oral sex.