As an educator, I frequently get questions about pubic lice, aka crabs.

Pubic lice (PL) affect people all over the world. PL are typically found in the genital hair, but have been found in leg hair, armpits, facial hair, eyebrows and eyelashes. The PL are usually spread through close sexual contact or contact with an infected person’s clothing (especially underwear), linens and used towels.

PL are usually more sluggish than head lice and attach themselves to several hairs. If someone is infected they usually don’t see the lice, but will probably see the nits (eggs). PL are annoying, itchy and a pain to treat, but are not going to cause any serious problems. The urban legend that you can get crabs from toilet seats is not true. PL are unable to walk on smooth surfaces and need to feed on blood from a live human body. They will die within 1-2 days if they are not attached to a person. So, if someone you have been with for a long time suddenly becomes infected with PL, call their bluff if they said they got it from a dirty bathroom. If you or your partner becomes infected with PL, you should also be tested for STDs.

Why are they called crabs?
When an adult pubic lice is viewed under a microscope it looks like a crab. It has two front legs that look like the pinchers on a crab, and four back legs.

How are they treated?
PL are treated with an over-the-counter medication or prescription shampoo, mousse, or lotion. Some people also remove their pubic hair. Clothing and linens should be machine washed and dried or placed in a tightly sealed plastic bag for two weeks to ensure the lice and nits have died. The infected person should notify any sexual partners they have had contact with in the previous month to seek treatment. They should not have contact with any sexual partners until they can ensure that they are lice-free.

Thankfully, in today’s modern culture we don’t see as many cases of PL. The medical community speculates that it is because of the trend towards shaving, waxing or trimming the pubic hair. Interesting fact: during the sixteenth century, women who were prostitutes used merkins (pubic wigs) to hide the that they shaved their pubic hair because of a pubic lice infection or lesions from STDs. People now use the merkins on movie sets to hide their waxed or shaven genitals or to ensure that the film is not considered full-frontal by the ratings system when they are nude onscreen.

For more information on STDs, visit the Centers for Disease Control.