Free risk assessment
Do I have pubic lice?
Pubic lice ("crabs") are tiny insects that live in coarse body hair and spread through close contact, usually sexual. Answer a few questions about your symptoms and risk factors to see how concerned to be and what to do next. This is a guide, not a diagnosis.
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Medically reviewed by Mark Riegel, MD · Updated June 2026
- Curable
- Yes
- OTC permethrin 1% cream rinse or pyrethrin/piperonyl-butoxide; two rounds 7–10 days apart are required
- Primary transmission
- Sexual contact
- close body-to-body contact; lice cannot jump or fly — they crawl between bodies during prolonged skin contact
- Declining prevalence
- Rare, decreasing
- pubic lice infestations have become less common, likely due to pubic hair removal trends
- Second treatment required
- Day 7–10
- nit eggs hatch in 6–10 days; repeat application kills newly hatched lice before they can lay more eggs
Many infections are silent. A low result here doesn't rule pubic lice (crabs) out. If you've had a new partner or any concern, testing is the only way to be sure.
About pubic lice (crabs)
What is pubic lice (crabs)?
Persistent itching down there, maybe worse at night? Pubic lice — nicknamed "crabs" for their claw-like legs — are one explanation worth checking. They're tiny insects, about the size of a sesame seed, that grip coarse body hair and feed on blood. The good news is you can usually see them: live lice crawling slowly in the hair, or pale eggs (nits) glued tight to the hair shafts.
They're nothing to do with how clean you are — anyone sexually active can get them, since close body contact is how they move from person to person. Treatment is simple and inexpensive, often an over-the-counter lotion. The one extra step that matters: because lice usually come from the same close contact that spreads other STIs, a full STI screen at the same visit is a smart move.
Screening guidance
Who should get tested for pubic lice (crabs)?
Because pubic lice (crabs) is often silent, the CDC recommends routine screening for the groups most likely to have it — not just people with symptoms.
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1
You have pubic-area itching
Itching in the genital or pubic area, often worse at night, is the main sign — look closely in good light, ideally with a magnifying glass, for lice or nits clinging to the hair.
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2
A partner has lice or has been scratching a lot
Anyone you've had sexual contact with in the past month should check and treat at the same time, even with no symptoms — lice can be spreading before the itch starts.
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3
You're getting a full STI screen after a new partner
Pubic lice ride along on the same close contact that spreads chlamydia, gonorrhea, syphilis, and HIV — finding them is a prompt to test for those too.
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4
You have eye or eyelash irritation after sexual contact
Lice can settle in the eyelashes or eyebrows and mimic conjunctivitis — a clinician can spot them and treat the eye area safely (ordinary lice products aren't safe there).
Timing
When a pubic lice (crabs) test is reliable
There's no lab window to wait out — lice and their eggs are visible the moment they're present, so diagnosis is simply a careful look at the hair (a clinician may use a magnifier or dermoscope). The itch can take 1–3 weeks to start as your skin reacts to louse saliva, and you can pass lice on during that time, so check whenever itching begins or a partner reports an infestation.
Eggs hatch in about 6–10 days, so a second treatment around day 7–10 is usually needed to kill newly hatched lice.
U.S. data
Pubic lice (crabs) in the United States
- Rare, declining
- pubic lice infestations — less common now due to pubic hair removal trends
Good to Know
Pubic lice (crabs) questions
Common questions about pubic lice (crabs) and pubic lice (crabs) testing, answered.
How do I know if I have pubic lice?
The main sign is itching in the genital area, often worse at night. You may see tiny lice or their pale eggs (nits) glued to coarse hairs, or small bluish spots or specks of dark 'dust' (droppings) in your underwear.
How do you get pubic lice?
Almost always through close body contact during sex. Less commonly they spread via shared bedding, towels, or clothing. They're not a sign of poor hygiene and can happen to anyone.
How are pubic lice treated?
Usually an over-the-counter permethrin or pyrethrin lotion made for lice; stubborn cases may need a prescription. You also need to wash bedding and clothing in hot water, and recent partners should be treated too.
Should I get an STI test if I have pubic lice?
Yes — having pubic lice means recent close sexual contact, and they often come alongside other STIs. A full STI screen is a sensible next step.
What if the lice are in my eyelashes?
Lice on the eyelashes or eyebrows shouldn't be treated with regular lice pesticides near the eyes — see a clinician for safe treatment. In children especially, eyelash involvement should prompt a careful check.
Trust & transparency
How this assessment works
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Grounded in public-health guidance
The questions — and how heavily each answer counts — follow the risk factors and symptoms the CDC and WHO describe for Pubic lice.
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A risk guide, not a diagnosis
Your answers produce a risk level — how concerned to be — and flag anything that needs urgent care. Only a lab test can confirm or rule out an infection.
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Private by design
It runs in your browser. We never ask for your name, email, or anything that identifies you.
Medically reviewed · Updated
Reviewed by Mark Riegel, MD · Sexual Health Physician · Chief Medical Reviewer
Physician focused on sexual health — STI testing, treatment and prevention — and EasySTD's chief medical reviewer. Owns the condition guides and is the clinical backstop for any page without a more specific specialist. Our editorial guidelines →
Sources & references
7 Sources
Clinical guidance
- CDC — Pubic 'Crab' Lice https://www.cdc.gov/parasites/lice/pubic/index.html
- CDC — STI Treatment Guidelines 2021: Ectoparasitic Infections — Pediculosis Pubis https://www.cdc.gov/std/treatment-guidelines/ectoparasitic.htm
- American Academy of Dermatology — Head Lice / Pubic Lice Overview https://www.aad.org/public/diseases/a-z/lice-overview
- MedlinePlus — Pubic Lice (Crabs) https://medlineplus.gov/ency/article/000841.htm
Data & references
- Abdel Nasser MB — Pubic lice (Pediculosis pubis) — declining in the developed world (Int J Dermatol 2007) https://pubmed.ncbi.nlm.nih.gov/17217370/
- Dolon BJ et al. — Pubic lice: an endangered species? (Sex Transm Infect 2014) https://pubmed.ncbi.nlm.nih.gov/24327518/
- Planned Parenthood — Pubic Lice https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/pubic-lice
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