Pubic lice — treatment and prevention
Reviewed by the My London Pharmacy clinical team, Trishla Shah, Pharmacist Independent Prescriber
·29 July 2026
·5 min read
Quick answer
Pubic lice, sometimes called crabs, are tiny insects that live in coarse body hair and cause itching. They spread mainly through close body contact. They are easily treated with an insecticide lotion or cream applied to the affected areas, repeated after a week, and washing bedding and clothing helps prevent their return.
What pubic lice are
Pubic lice are small parasitic insects, only a couple of millimetres long, that live in coarse body hair, most often in the pubic area. They are also known as crabs because of their crab-like shape and the claws they use to grip the hair. They feed on small amounts of blood from the skin, and it is this feeding that causes the characteristic itching.
They can also settle in other coarse hair such as on the chest, abdomen, armpits, beard and moustache, and occasionally the eyelashes and eyebrows, but not usually the finer hair on the scalp, which is where head lice live instead. Pubic lice are a different insect from head lice and body lice.
Pubic lice are common and, while the itching can be a real nuisance, they do not spread serious disease and are straightforward to treat at home. Having them is not a sign of being unclean, and they are nothing to feel ashamed about; they are simply passed on through close contact and are easily cleared once identified.
How they spread
Pubic lice are usually passed on through close body contact, most commonly during sex. Because they move by crawling from one person's hair to another's, they cannot jump or fly. This means they are passed on by direct contact rather than through the air.
Less often, they can spread through sharing bedding, towels or clothing with someone who has them. Having pubic lice is not a sign of poor hygiene; anyone who has close contact with an affected person can pick them up. They are not passed on by toilet seats.
Signs and symptoms
The most common symptom is itching in the affected area, which is an allergic reaction to the lice bites and is often worse at night when the lice are more active. It may take a week or more to develop after the lice first arrive, so you may not notice them straight away, and by then they may already have been present for a while.
Other signs include tiny pale eggs, called nits, firmly attached to the base of hairs, small specks of dark, powdery droppings on the skin or in underwear, and occasionally tiny spots of blood on the skin or small bluish marks where the lice have fed. Some people can just see the lice themselves, especially with a magnifying glass, as tiny greyish-brown insects moving in the hair.
If you are unsure whether what you are seeing is pubic lice, a clinician can confirm it quickly and put your mind at rest. It is worth checking rather than assuming, as the itching can have other causes, and getting the right diagnosis means the right treatment.
How pubic lice are treated
Pubic lice are treated with insecticide creams, lotions or liquids that you apply to the affected areas of the body, not just the pubic region, and wash off after the recommended time. A common option is Permethrin 5% Cream (generic Lyclear), applied to the affected areas and washed off after the recommended time. Other insecticides, such as malathion, may be recommended if one does not work.
Because these treatments do not always destroy every egg, a second application after seven days is usually advised to catch any lice that have since hatched. It is important to follow the instructions carefully, treat all the coarse body hair that is affected, and avoid close body contact until you and any partners have finished treatment. Lice affecting the eyelashes need a different approach, so a clinician should advise on those.
Treating your surroundings
Alongside treating your body, it helps to wash recently used bedding, towels and clothing at a hot temperature of at least sixty degrees, or seal items that cannot be washed in a plastic bag for a few days. Lice cannot survive long away from the warmth of the body, so this simple step reduces the chance of them returning.
There is no need to shave off pubic hair, and doing so is not a treatment on its own. Ordinary cleaning of your home is enough; there is no need for special sprays or intensive disinfecting.
Partners and check-ups
Anyone you have had close body contact or sex with in the past few months should be checked and, if needed, treated at the same time, even if they have no itching yet, since it can take weeks for symptoms to appear. Treating everyone together at the same time prevents the lice being passed back and forth, which is the most common reason they seem to return.
Because pubic lice are usually passed on through sexual contact, it is also sensible to consider a check for other sexually transmitted infections, as it is possible to have more than one at once and they often cause no symptoms. This is a normal, routine part of sexual health care.
A clinician can advise on testing discreetly and confidentially, and help with letting partners know if you would prefer not to raise it yourself. There is no judgement involved; the aim is simply to make sure everyone is treated and comfortable.
Preventing reinfestation
The most effective way to avoid pubic lice is to be aware that they spread through close contact, and to ensure that partners are treated at the same time so they are not passed straight back. Avoiding sharing towels, bedding and clothing with someone who has an active infestation also helps.
After treatment, a little ongoing itching can continue for a short while as the skin settles, which does not necessarily mean the lice are still present. If itching persists beyond a week or two, or you still see lice or eggs, a clinician can advise on repeating or changing treatment.
Frequently asked questions
Do I need to shave to get rid of pubic lice?
No. Shaving is not needed and does not clear the lice on its own. The insecticide treatment applied to the affected hair is what removes them.
Why do I need to treat twice?
A second application after seven days catches any lice that hatch from eggs the first treatment did not destroy, which helps prevent them returning.
Can I catch pubic lice from a toilet seat?
No. Pubic lice need close body contact to spread and cannot survive long away from the body, so toilet seats are not a source.
Should my partner be treated too?
Yes. Recent partners should be checked and treated at the same time, even without symptoms, to stop the lice being passed back and forth.
Are pubic lice a sign of poor hygiene?
No. Anyone in close contact with an affected person can get them. They are not related to how clean you are.