Pubic lice (crabs)

You or your healthcare professional most often can tell there are pubic lice by looking at your genital area. Seeing moving lice confirms the diagnosis.

Lice eggs, also called nits, may mean you have lice. But nits can continue to cling to hairs even when they die after treatment.

Treatment for pubic lice often starts with products that have permethrin or pyrethrin. These are products you can get without a prescription. You put them on the genital area. Follow the package directions closely and repeat the treatments as directed.

If you have only a few live lice and nits after treatment, you may be able to remove them using a nit comb or your fingernails. If you need more treatment, a healthcare professional may prescribe stronger treatments. These might include:

• Malathion. You put this prescription lotion on the area that has lice. Wash it off after 8 to 12 hours.
• Ivermectin (Stromectol). You take this medicine as a single dose of two pills. If that doesn't kill all the lice, you can take another dose in 7 to 10 days. Do not take this medicine if you are pregnant or breastfeeding.
• Eyelash and eyebrow treatments. To treat pubic lice in eyelashes and eyebrows, use a cotton swab to put petroleum jelly on them at night. Wash it off in the morning.

You may need to repeat this treatment for a few weeks. Take care not to get petroleum jelly in the eyes. Check and treat all hairy areas of the body. Lice can move away from treated areas to other hairy parts of the body. Sexual partners of anyone who's treated for public lice also need treatment.

To get rid of pubic lice, try these steps:

• Use lotions and shampoos. Choose from among lotions and shampoos made to kill lice (Nix, others) that you can get without a prescription. Use the product as the package instructs. You may need to repeat treatment in 7 to 10 days.
• Wash items that may have lice. Wash bedding, clothing and towels used in the 2 to 3 days before treatment. Use hot, soapy water that's at least 130 degrees Fahrenheit (54 degrees Celsius). Dry the items at the hottest setting for at least 20 minutes.
• Dry-clean or seal items you can't wash. If you can't wash an item, have it dry-cleaned. Or put it in an airtight bag for two weeks.

If you can't get rid of pubic lice on your own, you may need to talk to your healthcare professional.

What you can do

Before the appointment, write a list of answers to these questions:

• How long have you had pubic lice?
• What are your symptoms?
• How did you get lice?
• Have you had sex or shared sheets or towels since you got the pubic lice?
• What treatments have you tried?
• Do you have any long-term health conditions?
• What medicines, vitamins and supplements do you take? Include dosages.

What to expect from your doctor

During the physical exam, your healthcare professional checks your genital area for live lice or live lice eggs, called nits.