References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Pubic lice (Phthirus pubis), commonly called crabs, are tiny parasitic insects that live in coarse body hair — mainly pubic hair, but sometimes chest, armpit, beard or eyebrow hair. They spread through close body contact, usually during sex. They cause intense itching but are easily treated.
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Symptoms
- Intense itching in the pubic area
- Visible lice (about 2mm, greyish-brown)
- Eggs (nits) attached to hairs
- Blue-grey spots on the skin
- Dark powder in underwear (louse droppings)
How They Spread
| Route | Common? |
|---|---|
| Close body contact during sex | Main route |
| Shared towels or bedding | Rare |
| Clothing | Very rare |
| Toilet seats | No |
Treatment
- Insecticidal lotion (permethrin or malathion)
- Apply to all body hair, not just pubic
- Repeat after 7 days
- Treat all sexual partners simultaneously
- Wash bedding and clothing at 50°C+
Are Pubic Lice Less Common Now?
Yes — pubic lice are less commonly diagnosed than in the past, partly due to pubic hair grooming trends. But they haven’t disappeared and still occur.
Read more: Parasitic STIs | Crabs without sex | Scabies
Frequently Asked Questions
Can I see pubic lice?
Yes — they’re small but visible as greyish-brown specks on hair.
Do they carry diseases?
No — they cause itching but don’t transmit other infections.
Can I catch them from a toilet?
No — lice need body warmth and can’t survive on cold surfaces.
Related reading
- What Are Scabies?
- What Is a Female (Internal) Condom?
- What Is a Shigella Infection?
- What Is Bacterial Vaginosis (BV)?
- What Is Gonococcal Arthritis?
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
