Pubic Lice Symptoms

Quick Glance: Common Pubic Lice Symptoms

Pubic lice, also called crabs, usually affect coarse pubic hair but can also occur in other areas with coarse body hair. The most common pubic lice symptoms include:

• Intense itching around the pubic or genital area

• Itching that is often worse at night

• Small red, pink or bluish marks on the skin

• White, yellowish or pearly eggs firmly attached to hair shafts

• Visible pubic lice crawling on or attached to the hair

• Scratch marks, irritated skin or small sores

• Dark red or brown spots on underwear caused by lice faeces

• Lice or nits in other coarse-haired areas, such as the chest, armpits, beard or eyebrows

Not everyone develops noticeable symptoms. A mild infestation may be difficult to identify because there may be only a small number of lice, and the lice and their eggs can be difficult to see.

Symptoms of Pubic Lice That Should Not Be Ignored

The table below explains which pubic lice symptoms may need medical evaluation and what those symptoms could indicate:

Why Do Pubic Lice Symptoms Occur?

Pubic lice are tiny parasitic insects called Phthirus pubis. They usually live in coarse hair around the pubic or genital area and feed on human blood. They can also be found in coarse hair on the chest, armpits, beard, moustache, eyebrows and, less commonly, eyelashes.

Itching develops when the skin reacts to bites from the lice. This reaction causes irritation and inflammation in the affected area. Repeated scratching can then damage the skin, resulting in scratch marks, small sores and an increased risk of a secondary bacterial infection.

Pubic lice and their eggs can also produce visible signs. Nits are small eggs firmly attached to individual hair shafts, while adult pubic lice are small, grey-brown insects with a crab-like appearance. They can be difficult to see without close examination or magnification.

Some people develop small red or bluish marks at feeding sites. Pale blue or grey-blue marks, known as maculae caeruleae, can occur in some cases, but they are not present in everyone and cannot confirm pubic lice on their own.

Symptoms of Pubic Lice That Require Immediate Medical Attention

Pubic lice rarely cause a medical emergency. However, prompt medical assessment is important if you develop:

• Rapidly worsening redness, swelling or warmth around affected skin

• Pus, increasing pain or extensive sores

• Fever or feeling significantly unwell, along with signs of a skin infection

• Eye pain, marked redness or changes in vision when lice or eggs are present around the eyelashes

• Extensive or rapidly worsening infected sores

These symptoms may indicate a complication, such as a secondary bacterial skin infection, rather than the pubic lice infestation itself. Lice affecting the eyelashes also require medical assessment because the eye area needs specific care.

A severe allergic reaction, such as difficulty breathing, facial swelling or fainting, is also a medical emergency, regardless of its cause, and requires urgent medical care.

Symptoms of Pubic Lice in Children

Pubic lice are more common in adults, but children can also develop an infestation. Symptoms may include itching, visible lice or nits firmly attached to coarse body hair.

If pubic lice are found around a child's eyelashes or eyebrows, a healthcare professional should assess the child. In children, pubic lice in these areas can be associated with sexual exposure or abuse, although other possible routes of transmission should also be considered.

Can You Have Pubic Lice Without Symptoms?

Yes. Some people with pubic lice may have few or no noticeable symptoms, particularly when the infestation is mild. There may be only a small number of lice, making them difficult to see, and itching may not be obvious initially.

How are Pubic Lice Symptoms Diagnosed?

Pubic lice are usually diagnosed by examining the affected hair and skin for live lice or nits. A healthcare professional may use magnification when the lice or eggs are difficult to see.

The table below explains the main methods that may be used when assessing suspected pubic lice: