Pubic Lice (Crabs) Treatment

How Are Pubic Lice Treated?

You can usually treat pubic lice (also known as crabs) with shampoos, lotions, or a mousse you can buy at a drugstore without a prescription. Most of these products contain 1% permethrin or other chemicals that kill the lice. They’re safe and work well when you follow directions on the package or label.

If over-the-counter treatment doesn’t work, there are prescription treatments, too. One of these is lindane shampoo. But these treatments are more toxic. They aren’t recommended unless other treatments aren’t working or you can’t use over-the-counter treatments due to an allergy or other reason. If treatments you can buy at the store aren’t working, talk to your doctor.

Steps to Treat Pubic Lice

To get rid of pubic lice, follow these steps:

1. Remove pubic lice and eggs.

  • Wash and dry the area where the lice are.
  • Use an over-the-counter lotion or anti-lice shampoo (such as Nix, Rid, or others). Follow instructions on the label.
  • The shampoo will kill the lice, but eggs -- called nits -- may remain on hair shafts. After treatment, remove nits with fingernails, tweezers, or a fine-toothed comb. A mirror, magnifying glass, and a bright light may help.
  • Put on clean underwear and clothes.

2. Stop the spread.

  • Check other family members for crabs. Anyone who sleeps in the same bed as the person should be treated, even if no pubic lice are found.
  • Wash clothes, bedding, and towels used by the person in the 2 days before treatment. Use hot water (at least 130 F), and dry them on the hottest setting.
  • Dry-clean items that can't be washed, or store them in a plastic bag for 2 weeks.
  • Vacuum rugs and furniture.
  • Pubic lice rarely, if ever, are spread by someone sitting on a toilet seat. But, to be sure, clean and disinfect your bathroom.

3. Do a follow-up treatment.

  • You may need to repeat the treatment 9-10 days later.
  • Avoid any type of sex until the person and sexual partners have been treated and rechecked.

4. See a doctor:

  • To get checked for other sexually transmitted diseases
  • If a second round of over-the-counter treatment doesn’t work
  • If the person gets an infection from scratching the affected area
  • If fingers or combs aren't enough to remove lice or nits in eyebrows and eyelashes. The doctor can prescribe ophthalmic-grade petroleum jelly.

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on July 27, 2020

Sources

SOURCES:

CDC: "Pubic 'Crab' Lice, Fact Sheet," "Crab Lice, Treatment."

Mayo Clinic: “Pubic lice (crabs).”

Planned Parenthood: “How do I treat pubic lice?”

American Sexual Health Association: “Crabs.”

Pennsylvania Department of Health: “Pubic Lice Fact Sheet.”

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