Crabs, or pubic lice, are tiny, barely visible parasites. They are usually found in the pubic hair, but can also be found in other body areas with short hair. This may include eyelashes, eyebrows, armpit hair, and mustache hair.
Pubic lice are commonly called crabs because they look like tiny crabs.
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Over-the-counter shampoo or cream rinse containing permethrin or pyrethrins are used to treat pubic lice.
Some lice may be resistant to this treatment. For resistant cases, your doctor may advise:
- Malathion—A prescription topical medication approved only for those older than 6 years of age.
Lindane—A prescription topical medication.
- Note: Lindane should only be prescribed to patients who are unable to take other medications or who have not responded to them. According to the Food and Drug Administration’s warning, lindane can rarely cause serious side effects, including seizure and death. Those especially susceptible are infants, the elderly, children and adults weighing under 110 lbs, and individuals with other skin conditions. It should also not be used in pregnant or lactating women or in people who have uncontrolled seizures. Lindane is a toxin and should not be overused. Patients are given small amounts (1-2 oz) of the shampoo or lotion and instructed to apply a very thin layer and not to reapply.
- Ivermectin—A medication given by mouth. It cannot be used in pregnant or lactating women.
To reduce the chance of getting crabs or spreading crabs:
- Limit sexual partners.
- Watch for signs of crabs, such as itching in the genital area.
- If you or someone in your house has had crabs, thoroughly wash and dry bedding, towels, and clothing.
- If you have had crabs, inform any sexual partners that they are at risk for crabs. Avoid sexual activity until partners have been treated.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Edits to original content made by Denver Health.
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a (Pubic Lice; Pediculosis Pubis)
American Academy of Dermatology https://www.aad.org
The American Congress of Obstetrics and Gynecology http://www.acog.org
Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR 2010;59(No. RR-12):1-110.
Lindane shampoo and lindane lotion. Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm110452.htm. Accessed May 28, 2015.
Medication guide lindane shampoo. Food and Drug Administration website. Available at: http://www.accessdata.fda.gov/drugsatfda%5Fdocs/label/2003/006309shampoolbl.pdf. Accessed May 28, 2015.
Parasites—lice. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/parasites/lice. Updated September 24, 2013. Accessed May 28, 2015.