Plenty more fish in the sea?  But all you end up with is crabs?

Pubic lice are sexually transmitted via direct skin-to-skin contact.  A condom does not protect you from pubic lice.  A common misconception is that they only live in pubic hair.  With the recent trends in pubic hair removal, some people think pubic lice cannot affect them cause no pubic hair would mean no pubic lice, right?

Wrong!

Pubic lice don’t just love pubic hair.  They love armpit hair, eyebrows, eyelashes, chest hair, and beards.  In fact, they love all types of hair, except the hair on your head.  Picky bastards!  The lice you commonly see in the hair on the head, referred to as nits, are different types of the parasite to pubic lice.  Pubic lice are not nits, and nits are not pubic lice who are lost.

So what are they?

They are small, flat, light brown parasites that cling to pubic hair and suck your blood for nourishment.  Basically, mini vampiric bugs.  This act of sucking blood can result in small red areas or sores, itching on your skin as they inject their saliva into your skin as they suck.

Pubic lice predominately spread through sexual contact.  However, they can also spread by contact with the infected person’s towels, bedding, and undergarments.  A condom doesn’t protect you from pubic lice.  Protection comes down to being aware of your surroundings, open communication with your partner on current sexual health status, visual inspection, and trust. 

Pubic lice can’t jump nor fly, so it’s not like you unintentionally walked into a holocaust swarm of pubic lice.  It is spread by direct contact.  They only affect humans, so you cannot catch them off pets or animals.  No blaming the pet dogs or cats, please!  You can’t catch them off a public toilet seat.  This is a common misconception, but pubic lice don’t live long off pubic hair; they do not have the grip to hold on to a toilet seat long enough to reinfect someone.

So, how common are they?

Millions of people get pubic lice every year, with roughly 3 million in the US alone getting them yearly.  Getting them doesn’t mean you are dirty, sexually promiscuous, or unclean.  It has nothing to do with hygiene, cleanliness, or how many people you have sex with.

So how do I know if I’ve got a cast of crabs?

Common signs and symptoms include itching around your genital or anal area.  Tiny blue spots around your genitals.  Streaks of blood or fine, gritty debris in your undies.  Sometimes, you can see the lice or eggs in your pubic or other hair. 

One key recommendation if you find yourself with pubic lice is to go for a health check-up with your doctor.  It is good practice to check if you haven’t inadvertently picked up an STI from the encounter.  But, Jodi, you said crabs are not a sign of a sexually promiscuous person, so why should I get an STI check-up?  Well, the reality is that a lot of sexually transmitted infections are asymptomatic.  Pubic lice are not asymptomatic, so someone who has them would know they have them.  Therefore, if they are not getting their pubic lice treated, it begs the question of what else they may not be getting treated?  At the end of the day, it’s a good situation to get an overall sexual health check-up.

How do we get rid of them?

People often think they can remove pubic lice by washing or shaving their pubic hair.  The reality is that pubic lice don’t need much hair to stick to, plus remember it isn’t just pubic hair they love.  So will we shave our eyebrows or pluck our eyelashes if they end up there?  No, I didn’t think so.

The first step is to get an over-the-counter lice treatment that contains permethrin, and you will need to apply this to your whole body from neck to toes.  You do not need to use this on the hair on your head.  However, suppose pubic lice are in your eyebrows and eyelashes.  You should see your healthcare professional so specific treatment for that sensitive area is prescribed and applied.  Leave the cream on overnight and wash it off in the morning.  You will also need to wash all bedding, towels, and clothing.  You must repeat the treatment at 1 and 2 weeks to catch the unhatched eggs of the pubic lice.

Remember, pubic lice still exist.  They are not considered an STI; however, they must be treated to stop cross-infection.