
Pubic lice (crabs) are annoying but harmless parasites that are usually transmitted through physical contact. You can also contract them by sharing contaminated clothing, bedding, or towels, for example.
The lice feed on human blood and can be found on all areas of the body that have hair, but not on the scalp (lice in the scalp are head lice). Pubic lice are easy to identify: you will see little dots on the pubic hair. These are the eggs or nits of the lice. The lice themselves are also visible and often move through the pubic hair, looking like small spiders (1-3 mm). Pubic lice are fairly easy to treat with special treatments.
Symptoms
About two weeks after coming into contact with the (eggs of) pubic lice, you may experience persistent itching. This is an allergic reaction to the bites of the lice. The lice usually reside in the hair around the genitals and anus, sometimes also on other body hair and even in the eyelashes and eyebrows. The lice feed on human blood, leaving red or brown spots of feces in the underwear. On the skin, the lice bites leave gray-blue spots.
Possible complications
Scratching can cause the skin to become red and irritated. If wounds occur, this can lead to skin infections.
Treatment
Washing with water and regular soap or shampoo is not effective against pubic lice. You can obtain a lice treatment from your doctor or at a pharmacy without a prescription. The treatment is applied to the pubic hair, the hair on the inside of the thighs, and all affected hair, excluding the eyelashes. Twelve hours after treatment, all lice and nits are dead. In case of a severe infection, it’s advisable to repeat the treatment after a week. Lice and nits in the eyelashes can be treated by applying petroleum jelly twice daily for ten days. Alternatively, lice can be removed with tweezers, and nits can be scraped off the eyelashes with your fingernails. Clothing and bedding should be washed (at 60°C), steamed, or dry-cleaned. To prevent reinfection, it’s important that partners also get treated, even if they don’t have symptoms yet.
If someone has contracted pubic lice through sexual contact, it’s advisable to also get tested for other STDs.
Partner warning
It is important to inform all sexual partners from the last two months and have them treated as well.

Adult pubic louse (approximately 1.5 mm long) and a nit attached to a hair.
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