What exactly are pubic lice?
Pubic lice is a sexually transmitted infection that’s unfortunately hard to protect against with condoms. Americans get around three million cases of pubic lice each year, according to Planned Parenthood. “Pubic lice are ectoparasites, meaning they tend to thrive outside of the body instead of in it,” Jamil Abdur-Rahman, M.D., board-certified ob/gyn and chairman of obstetrics and gynecology at Vista East Medical Center in Waukegan, Illinois. Although they’re in the same family as head lice, they’re two different things. (Fun fact: Both feed on blood.) Pubic lice thrive in pubic hair and don’t generally venture up to the scalp, although they are also sometimes found in areas like the underarms, eyelashes, and eyebrows. “If you’re intimate with someone who has pubic lice, they can transfer right on over,” says Abdur-Rahman.
Still, ob/gyns are seeing them less than they used to, potentially because of pubic hair grooming practices. “Eighty to 90 percent of the patients I see are completely clean-shaven,” says Abdur-Rahman. But the pubic-hair tide may be shifting; a December 2014 New York Times piece chronicled the rise of “a fuller look,” it’s kind of impossible to get in on the recent oiling-your-pubic-hair trend if you don’t have any, and there’s been a general move towards body acceptance of all kinds, including when it comes to hair on women. The point: Pubic lice are still an issue.
Pubic lice have three different life stages, according to the Centers for Disease Control and Prevention (CDC). They start as nits, or eggs, hatch into nymphs after six to 10 days, then become adults after about two or three more weeks. The adults look exactly like what you’re picturing: mini-crabs with six legs, two of which look like pincers. The more they feast on blood, the larger they get, and they can reach up to two millimeters when they’re full-grown. At that point, you may be able to see them with the naked eye—before then, a magnifying glass can make it easier.
How are they diagnosed and treated?
People don’t often see pubic lice, then get themselves to the doctor. Instead, they usually seek medical attention because of annoying symptoms. “Most people with pubic lice will complain of two things. One is tons of itching, and the other is irritation of the skin,” says Abdur-Rahman. “Part of that irritation comes from the fact that the lice are attaching to the skin and leaching blood out. But the other part is that people often voluntarily or involuntarily scratch the skin, so they come in thinking they have a rash.”
There are over-the-counter and prescription treatments to deal with pubic lice, and they’re often the same ones used for head lice. These medications generally work by interfering with the lice’s nerve functioning so they die off, says Abdur-Rahman. They usually involve applying the treatment, rinsing it off, then combing through your pubic hair, according to the U.S. National Library of Medicine. But pubic lice can also hang out in clothing, towels, and bedding, so cleaning those is a must as well.
Is there any way to avoid getting pubic lice?
Although it’s technically possible to spread pubic lice through thing like shared clothing or bedding, they’re usually spread via sexual contact, says Abdur-Rahman. Unfortunately, condoms don’t really protect against them. It’s key to go to a doctor if you’re experiencing symptoms. Home remedies like shaving or waxing your pubic hair off aren’t viable treatments, says Abdur-Rahman.
One point of relief: The threat of getting them from toilet seats is basically nonexistent. “This would be extremely rare because lice cannot live long away from a warm human body, and they do not have feet designed to hold onto or walk on smooth surfaces such as toilet seats,” says the CDC.
Another piece of good news is that even though condoms don’t protect you from pubic lice, crabs don’t make you more susceptible to other STIs. “With something like chlamydia, you have inflammation of the cervix which makes it easy for another infection to permeate what is normally a pretty airtight area, if you will,” says Abdur-Rahman. “But since lice aren’t affecting the mucus membranes, they wouldn’t increase the risk of other sexually transmitted infections.” Once you get treatment—and inform whoever you think transmitted pubic lice to you in the first place—you can put it behind you. And even though condoms don’t protect against pubic lice, doctors generally think those who get crabs or any other sexually transmitted infections may be engaging in risky sexual behavior. Stocking up on some rubbers, or whichever safe-sex method you prefer, is always a good idea.