Pubic lice

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Pubic lice, also known as crabs, are tiny insects that live on coarse human body hair, such as the pubic hair around the penis or vagina. They are not linked to poor personal hygiene.

Symptoms can take up to 3 weeks to show after you come into contact with pubic lice.

The most common symptom is itchy red spots. The itching comes from an allergy to the lice's saliva or poo. After the first infestation, it can take 1 to 3 weeks for the itching to start, and it's usually worse at night.

Pubic lice are very small (2mm long) and grey-brown in colour. They're hard to spot, but sometimes you may see them in your hair. They live mostly on pubic hair, though they can also be found in hair on the chest, armpits, face and eyelashes. They do not affect the hair on your head.

You may also notice these symptoms:

• small red or blue spots on your skin (lice bites)
• white or yellow dots attached to your hair (lice eggs)
• dark red or brown spots in your underwear (lice poo)
• crusty or sticky eyelashes, if they're infected

• you think you might have pubic lice

There's no test for pubic lice. Your doctor or nurse will simply check your hair for lice, and that may include the pubic hair around your penis or vagina and any other areas that could be affected.

To help spot the lice, your doctor or nurse may use a comb and a magnifying lens.

You can also buy treatment over the counter at your local pharmacy, though the pharmacist won't be able to diagnose the infestation.

Pubic lice are treated with medicated creams or shampoos that kill the lice.

You'll usually need to put the treatment on your whole body and leave it on for a few hours before washing it off. Then you repeat it a week later, so that all the lice are killed.

You may be asked to go back to your doctor or a sexual health clinic once you've finished treatment, so they can check that it has worked.

Your partner or partners should be treated too, even if they have no symptoms.

Some pubic lice can resist treatment, which means a particular treatment won't affect them. If your symptoms don't settle, you may need to try more than one type of treatment.

Speak to your doctor if your first treatment hasn't worked.

Lice around the eye area are usually treated differently from lice elsewhere on the body. Some creams and lotions aren't safe to use near the eyes. Instead, you can remove the lice with tweezers, or put Vaseline on them first to suffocate them and then take them off.

While you're being treated for pubic lice, there are a few things you can do to stop the lice spreading to other people.

• Wash your clothes and bedding on a hot wash (50 degrees or higher), have them dry cleaned, or seal them in a plastic bag for at least a week. This will help kill any lice.
• Vacuum your mattress to remove any lice.

• Don't share clothes, bedding or hygiene products (this includes razors).
• Don't have any close body contact with anyone while you're being treated, and that includes sexual contact.

Pubic lice spread through close body contact with a person who already has them, and most often this means sexual contact.

The lice crawl from one hair to another, but they can't fly or jump. They need human blood to survive, so they generally leave the body only to move from one person to another.

Pubic lice don't live on other animals such as cats or dogs.

If you or your partner has pubic lice, avoid having sex (vaginal, anal or oral). Avoid close bodily contact too. Keep this up until you've both finished treatment, including any follow-up treatment.

Pubic lice spread easily, and condoms don't protect you against them. The more people you have intimate or sexual contact with, the higher your chance of catching them, so limiting the number of people you have that contact with lowers your risk.

If you've been diagnosed with pubic lice, you should get tested for other STIs as well, including:

• gonorrhoea
• chlamydia
• syphilis