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Pubic lice, commonly known as crabs (Phthirus pubis), are tiny parasitic insects that primarily infest coarse body hair, most notably the pubic region. They can also be found in other areas with coarse hair, such as armpits, chest, beard, mustache, eyebrows, and eyelashes. These lice are parasites that feed on human blood, and their bites cause intense itching. Pubic lice are most frequently transmitted through close body contact, predominantly sexual activity. While causing discomfort, pubic lice infestations generally do not lead to serious long-term health problems.
Common symptoms
Intense itching in the affected hairy areas, especially in the pubic region, often worsening at night.
Irritated skin, which may appear red or bloody due to scratching.
Small red or blue spots on the skin, which are bite marks from the lice.
Specks of black powder (lice droppings) in underwear.
Small white or yellowish dots (nits or lice eggs) firmly attached to the base of hair shafts, difficult to remove.
Pale bluish spots on the thighs, buttocks, or lower abdomen (less common).
Low-grade fever and feeling run-down (less common).
Crusted or sticky eyelashes, if infested (more common in children).
Possible causes
Close body contact with an infested person, most commonly during sexual intercourse.
Sharing personal items such as towels, bedding, or clothing with someone who has pubic lice (less common).
Medical treatment
Over-the-counter (OTC) medicated creams, lotions, or shampoos containing 1% permethrin or pyrethrins with piperonyl butoxide, applied to the affected hairy areas following package instructions.
For resistant cases or if OTC treatments fail, a healthcare provider may prescribe stronger topical creams, shampoos, or oral medications like ivermectin or malathion. Lindane shampoo is a potent option but typically reserved for when other treatments are ineffective due to potential serious side effects.
Repeat the treatment in 9-10 days or 1-2 weeks, as the initial application may not kill unhatched eggs, to eliminate any newly hatched lice.
Machine-wash and machine-dry all clothing, bedding, and towels used by the infested person in hot water (at least 50°C or 130°F) and use the hot cycle of the dryer to kill lice and eggs.
For items that cannot be washed, dry clean them or seal them in a plastic bag for at least two weeks (10-14 days) to smother the lice.
Remove nits (eggs) from hair strands using fingers, tweezers, or a fine-toothed comb.
Avoid sexual contact and other close body contact until treatment is complete and all partners have been treated.
For pubic lice on eyelashes, a special prescription ointment applied twice daily for 8 days may be necessary, and consultation with an ophthalmologist might be recommended.
Antihistamines can be used to help alleviate itching.
Ayurvedic perspective
In Ayurveda, infestations like pubic lice fall under the broad category of 'Krimi Roga,' which refers to parasitic infestations. External parasites, specifically, are known as 'Bahya Krimi'. Pubic lice infestations are often associated with an increase in Pitta dosha, or fire energy, which manifests as rashes, intense itching, and irritation in the reproductive and pelvic areas. A weakened digestive fire (Agni) and the accumulation of toxins (Ama) are considered primary factors that create a favorable environment for parasites to thrive. Factors contributing to Krimi manifestation also include unhygienic conditions, consumption of mutually contradictory foods, and excessive intake of certain items like black gram, radish, sesame, milk, and jaggery.
Ayurvedic dietary guidelines
Avoid foods that cause dosha imbalance, as well as cold, dry, and hard-to-digest foods.
Limit the overuse of milk, curd, jaggery, meat, and fish in the diet.
Refrain from excessive sugar, processed foods, and raw or undercooked meats.
Incorporate turmeric into your diet.
Favor bitter and astringent foods, herbal teas, and warm water.
Consume freshly cooked, warm, and easily digestible meals.
Include anti-parasitic foods such as coconut, fresh pineapple, and pumpkin seeds.
Add digestive spices like ginger, fennel, coriander, black pepper, trikatu, cloves, cayenne pepper (in moderation), and cinnamon.
Include garlic and green onion in your diet.
Optimize intestinal flora by consuming probiotic-rich foods like yogurt or kefir.
Avoid unhygienic living conditions, which are risk factors for parasitic infestations.
Wash hands frequently, especially before eating and after using the bathroom or cleaning up after pets.
Launder all contaminated towels, bed linens, and clothing in hot water, as lice and eggs can survive off the body for short periods.
Avoid sharing personal items like hats, combs, and bedding to prevent transmission.
Avoid sexual contact until the infestation is fully treated to prevent re-infestation.
Incorporate practices like yoga, meditation, and stress management to enhance overall health and immunity, which helps in preventing parasitic infestations.
