Pubic Lice: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Pubic Lice?
A primary care doctor, such as a family medicine doctor, can usually diagnose and treat pubic lice, which are tiny insects that live in body hair. A dermatologist, a doctor who treats skin conditions, can also help. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What are pubic lice?
Pubic lice are also called "crab" lice. They are parasitic insects, which means they live on another living thing and feed on it. Pubic lice feed on human blood. They are short and crab-like, and they look very different from head and body lice.
Pubic lice usually attach to hair in the pubic area. They can also be found in other hairy areas, such as the eyelashes, eyebrows, beard, mustache, armpits, chest, and back.
Symptoms
Signs of pubic lice include:
- Itching in the genital area, which often gets worse at night.
- Visible nits, which are lice eggs.
- Lice crawling or attached to pubic hair.
- Skin that turns red or bluish-gray where the lice bite.
- Sores in the genital area from bites and scratching.
The itching may start soon after you get lice. It may also not start for up to 2 to 4 weeks after contact.
Causes and who gets it
Anyone can get pubic lice. They are most common in adults. You usually get them from close person-to-person contact, most often sexual contact.
Occasionally, pubic lice spread through clothing or bedding. Very rarely, they spread through a toilet seat that an infested person just used. You are at higher risk if you have many sexual partners or share bedding or clothing with an infested person.
Pubic lice found on the head or eyelashes of children may be a sign of sexual exposure or abuse. Doctors always consider this when they find pubic lice in a child.
How doctors diagnose it
Doctors diagnose pubic lice by finding a louse or nits on hair in the pubic area or, less often, elsewhere on the body. The lice and nits can be large enough to see with the naked eye, but a magnifying lens may help.
A provider will also look for scratch marks and signs of a skin infection. Teenagers and adults may need tests for other sexually transmitted infections. Lice found on the head are generally head lice, not pubic lice.
Treatment
You can treat pubic lice with a lice-killing lotion that contains permethrin or a mousse that contains pyrethrins and piperonyl butoxide. You can buy these at a drug store without a prescription. They are safe and effective when you use them exactly as the package or label says.
Key steps include:
- Wash the infested area and dry it with a towel before treatment.
- Remove nits with your fingernails or a fine-toothed comb after treatment.
- Machine-wash and machine-dry the clothing, towels, and bedding you used in the 2 to 3 days before treatment. Use hot water and the hot dryer cycle.
- Tell all sex partners from the past month that they need treatment.
- Avoid sexual contact until you and your partners have been treated.
- Repeat treatment in 9 to 10 days if you still find live lice.
Do not use these lice medicines near the eyes. Lice on the eyebrows or eyelashes need special directions. Do not use fumigant sprays or fogs, because they are not needed and can be toxic.
When to see a doctor
Contact a provider if you or a sexual partner has symptoms of pubic lice. Also contact one if over-the-counter treatment does not work or if your symptoms continue after treatment. Scratching can make the skin raw or cause a skin infection.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can confirm the diagnosis, review treatment steps, and arrange testing for other sexually transmitted infections.
Common questions
Can pubic lice spread disease?
No, pubic lice do not transmit disease. However, intense scratching can cause sores and a bacterial infection, and a provider may test you for other sexually transmitted infections.
Does shaving get rid of pubic lice?
No. Shaving and other hair removal methods, such as waxing and sugaring, will not get rid of pubic lice.
Can you get pubic lice from a toilet seat?
It is very rare. Pubic lice usually spread through sexual contact, and only occasionally through clothing or bedding.
Can pets give you pubic lice?
No. Animals do not get or spread pubic lice.
Sources
- Centers for Disease Control and Prevention - About Pubic "Crab" Lice
- Centers for Disease Control and Prevention - Treatment of Pubic Lice
- MedlinePlus - Pubic lice
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
