Crab Lice

What are crabs?

Lice are bad enough when you get them on your scalp. But if you catch pubic lice -- more commonly known as crabs -- you're in for some really itchy times.

Pubic lice are smaller and rounder than head lice, but they are every bit as aggravating. If a female crab lays eggs in your pubic area, the young hatchlings will start burrowing into your hair follicles within a few weeks. They'll live there for a month or so, feasting on your blood and making you extremely uncomfortable.

The little pests aren't exactly rare. About 3 million Americans seek treatment for crabs every year.

How can I tell if I have crabs?

If you have a case of crabs, you'll know something is up. The skin under your pubic hair will itch non-stop. If you take a look down there, the crabs are easy to find, especially if you use a magnifying glass. Adult lice are pale gray and about the size of a pinhead. They may be a darker color if they've recently gorged on your blood. You may see pale gray, oval-shaped eggs or nits at the base of your hairs. The eggs may look like dandruff, but they cant be brushed away.

Pubic lice can sometimes spread to other parts of the body, including eyebrows, eyelashes, beard, mustache, or other body hair.

How did I get crabs?

Most people catch crabs by having sex -- or at least skin-to-skin contact -- with someone who already has crabs. Less often, people catch them from infested towels, clothes, or bedding. Lice can survive an entire day away from a human host. It's worth noting that lice are very rarely found on toilet seats; they don't really have any interest in hard, smooth surfaces.

What should I do about crabs?

First of all, try not to scratch. Scratching can leave sores in your skin and open the possibility of infection. You could also end up spreading the crabs if you touch another part of your body like your eyebrows or armpits after a vigorous scratching session.

Fortunately, the over-the-counter lotions and shampoos used to tread head lice will kill crabs, too. Look for products containing permethrin or pyrethrum extracts, which are sold under such brand names as RID, Nix, and A-200. If you're pregnant, you'll need to use a specially formulated product called Eurax. After using the lotion or shampoo, remove the nits with a nit comb, available at drug stores.

It probably goes without saying that you shouldn't use kerosene or gasoline to kill crabs. These home remedies are from a time when people didn't have any better, less toxic options. Also, you shouldn't use any sort of pesticides on your eyebrows or eyelashes. If you have crabs around your eyes, check with your doctor for advice. You may end up with a prescription-only petroleum jelly designed to smother the crabs.

How can I keep them from coming back?

  • Once you've removed the lice from your body, you'll have to head to the laundry room to remove them from your bedding and clothes. Use hot water and a high dryer setting.
  • Seal all of your combs and brushes in a plastic bag for at least two weeks, long enough to starve the hatchlings from any remaining eggs.
  • If you know that you caught crabs from a particular sexual partner, you'll obviously want to make sure that he or she gets treated too before you have sex again.
  • Talk to a close friend, support group, or counselor. It's not uncommon to feel anxious, guilty, or lonely, especially when you've just been diagnosed. But you have no reason to felt guilty or ashamed; there is nothing wrong with being sexual. Talking to someone about it will help you feel better and reduce your stress, which will help you avoid recurrences.

References

Centers for Disease Control and Prevention. Pubic Lice or "Crabs." http://www.cdc.gov/parasites/lice/pubic/index.html

Witkowski JA, et al. What's New in the Management of Lice. 1997 Infect Med 14(4):287-288, 294-296.

Centers for Disease Control. Pubic "Crab" Lice: Treatment. May 2008. http://www.cdc.gov/parasites/lice/pubic/treatment.html

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