How to Treat and Prevent Crabs

Medically reviewed by Lacy Windham, MD

Last Updated: October 28, 2024 References

Experts say you can contract crabs (pubic lice) during sexual intercourse or while sharing clothes, linens, or towels with an infected person.^{[1]
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Research source} Crabs are a parasite that infests your genital and pubic area, but they may also find their way to coarse hair like your leg hair, mustache, beard, eyebrows, eyelashes and armpits. Fortunately, it's possible to prevent a crab infestation, and they're fairly easy to treat if you do come into contact with them. Research suggests that pubic lice can usually be treated with over-the-counter lice treatments, though you'll also need to pick out the eggs, which will be attached to the hair shafts.^{[2]
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Method 1

Method 1 of 4:

Choosing Your Treatment

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1
Purchase a lotion that contains 1% permethrin. Products containing permethrin, pyrethrins, or piperonyl butoxide are very effective against pubic lice. You can purchase a lotion, cream, or mousse that contains permethrin without a prescription, or you can ask your doctor to prescribe one for you. Permethrin inhibits the crabs' nerve impulses, affecting their breathing – in other words, it suffocates them and they die.^{[3]
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Go to source} Brand name examples are Rid, Nix, and Pyrinex.
- Read and follow the package instructions for any over the counter or prescription product that you obtain. If you have any questions about how to use this product, ask your doctor or pharmacist.
2
Consider using a malathion 0.5% lotion (Ovide). Malathion kills live lice and some, but not all, nits. Malathion is approved by the U.S. Food and Drug Administration (FDA) only for the treatment of head lice, but has shown efficacy in the treatment of pubic lice.^{[4]
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- Read and follow the package instructions for any over the counter or prescription product that you obtain. If you have any questions about how to use this product, ask your doctor or pharmacist.
- Malathion lotion is flammable so do not apply around open flames or other heat sources.
- Malathion 0.5% lotion should only be used on persons 6 years of age or older.^{[5]
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3
Ask your doctor about ivermectin. If creams and lotions have not worked for you, talk to your doctor about ivermectin. Ivermectin is a prescription drug given in the form of tablets. A single dose of two pills is usually enough to treat the condition.^{[6]
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Research source} Common names are Heartgard and Stromectol.
- Read and follow the package instructions for this product. If you have any questions about how to use this product, ask your doctor or pharmacist.
- Oral ivermectin is not approved by the FDA for the treatment of pubic lice, but has been shown to be effective. In the U. S., the drug is not labeled for use in children weighing less than 15 kg (33 pounds). Women who are pregnant or breast-feeding should not use ivermectin.^{[7]
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4
Ask your doctor about Lindane shampoo or lotion if nothing else works. Lindane is a prescription medication which is now only used as a last resort treatment. It is very efficient and effective in treating pubic lice, but it also has the potential for serious nervous system side effects such as seizures.^{[9]
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Go to source} As a result, Lindane is not used as first-line therapy for the treatment of pubic lice. Its use should be restricted to individuals who have failed treatment with or cannot tolerate other medications that pose less risk. Lindane should not be used to treat:
- premature infants
- persons with a seizure disorder
- women who are pregnant or breastfeeding
- persons with very irritated skin or sores where lindane is to be applied
- persons weighing less than 110 pounds^{[10]
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  - If your doctor has prescribed Lindane for you, it may be because the potential benefits outweigh the risks, but you should talk to your doctor if you have concerns about using the product.
  - Read and follow the package instructions before using this product. If you have any questions about how to use this product, ask your doctor or pharmacist.

Method 2

Method 2 of 4:

Getting Rid of Crabs

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1
Wash the genital area. Thoroughly clean your genital area before applying any kind of lice lotion or cream. Your skin will absorb the lotion better if dirt and dust are removed from the skin and pubic hair.
- Right after washing and cleaning the genital area, be sure to dry it thoroughly as most of the creams and lotions need to be applied on dry and clean hair.^{[11]
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2
Apply the lice-killing product that you have selected. Read and follow the package instructions carefully to get the most benefit from the product that you have chosen. Remember to ask your doctor if you have any questions about how to use the product.^{[12]
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- Thoroughly saturate the infested area with the product, according to the directions on the package.
Shampoos may only need to be left on for about 10 minutes, but lotions and creams may need to be left on for 8-14 hours. Note the time when you apply the product and set a timer or watch the time.^{[13]
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4
Rinse off the medication and dry thoroughly. After you have left the product on for the indicated amount of time, rinse it off with warm water. Rinsing away the product will help to remove dead nits and lice from your skin. It is important to rinse the dead parasites away because they may lead to hygiene problems if left on your skin.^{[14]
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- Be sure to separate the towels you used from your other clothes and linens. Wash the towels separately to avoid cross-contamination to other clothing and linens.
- In some cases where nits stay in the base of the hair, you can just remove them using your fingernails or a fine toothed comb.
Make sure that you put on clean, fresh undergarments and clothing to prevent a recurrence of the infestation. Any clothes that you wore when you had crabs should be immediately laundered.
6
Wash all fabrics that could be contaminated. Infested clothes, bed linens, and towels should be washed in hot water. The hotter your washing machine goes, the better. Use at least 130F water. All clothes and linens should also be dried in a hot dryer until they are completely dry.^{[15]
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- You should wash any soft materials that you used 2-3 days before your treatment.^{[16]
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- Infested blankets, quilts, and carpets can be stored in a sealed plastic bag for 1 to 2 weeks to eventually kill the lice. This way, they are not able to feed on any blood and subsequently die.
7
Repeat treatment if lice are still present. You can repeat the procedure in about a week. Follow the directions on the box or from your doctor. Even if you think the crabs are gone, it's best to repeat treatment just to be sure.^{[17]
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- There are some cases where lice relocate to other areas and will come back right after treating your genital area; however, this doesn't happen often.

Method 3

Method 3 of 4:

Using Natural Remedies

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If you only have a few crabs, using a nit comb to remove pubic lice and nits is one of the simplest and most cost effective treatments for the parasite. The treatment is also time consuming as it can take up to 14 days to manually get rid of all lice and nits. It is very common to combine this technique with another natural treatment.
2
Apply petroleum jelly (Vaseline). Petroleum jelly suffocates the lice on your pubic hair. Apply petroleum jelly generously to the pubic area. Make sure that the jelly covers the base of the pubic hair to make it easier to remove nits with a nit comb. You may apply petroleum jelly as many times as needed to get rid of the lice and nits.
- Be aware that regular petroleum jelly should not be used to treat pubic lice and nits in the eyebrows or eyelashes because it can be very irritating to the eye. However, your doctor can prescribe an ophthalmic grade petroleum jelly that can be applied to the eyebrows and eyelashes.^{[18]
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Trimming pubic hair as short as possible will increase the effectiveness of other treatments for pubic lice, whether natural, over-the-counter, or prescription. It is important to note that just shaving pubic hair is not an effective treatment for pubic lice, as they may simply relocate to other hairy areas of the body.^{[19]
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Method 4

Method 4 of 4:

Preventing Recurrences

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1
Avoid any close contact or sexual contact. Since crabs are often sexually transmitted, it is best to avoid any sexual activity unless you are totally lice free. Any close contact such as sleeping with someone or staying too close to a person infested with crabs will increase your chances of getting them again.
- Although using a latex or polyurethane condom protects against most STIs, condom use does not adequately protect against crabs.^{[20]
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As with all STIs, the greater the number of your sexual partners, the greater your chances of getting – and spreading – crabs.^{[21]
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Research source} It's possible, in the early stages, to not know you have crabs. Therefore, limiting your sexual activity is best.^{[22]
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3
Tell any person you're in close contact with to get treated. For their health, tell them that you are treating yourself for lice and they should get treatment as well. Talking to a girlfriend or boyfriend about your pubic lice may be embarrassing, but it avoids creating a larger problem – and they'll probably figure it out eventually regardless.
- Don't partake in any sexual contact with the person until they are treated, too. Both parties should be treated before engaging in any sexual activity again.^{[23]
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4
Avoid sharing your personal things. Combs, towels, pillows, and blankets should not be shared with any other person if either of you is or was infested with crabs. It is always better to use your own personal things rather than borrowing to avoid any possible issues with others.^{[24]
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- Anything that has come into close contact with your hair and skin may be infested, from hairbrushes and combs to towels, sheets, and pillows. If there's any risk at all, just avoid it by sterilizing the item and keeping it to yourself.
5
Clean your bed sheets before using them again. While you're sleeping, lice are free to move anywhere and can settle in any part of the bed. Before and after your treatment, bed linens and pillow cases should be replaced and washed thoroughly to avoid any possible recurrences.^{[25]
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- Feel free to wash surfaces, like in your bathroom, too. Washing surfaces with warm water and disinfectant solutions will help immobilize and kill the organisms.
- Washing clothes above the 30 °C (86 °F) mark on your washing machine along with detergent and conditioner will help keep your clothes free from infestation.

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Follow any special advice given to you by your doctor as well as what's written on the label of the lotion/medication.

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Warnings

Read the precautions on any over the counter or prescription product that you use to treat your pubic lice. If you experience any of the serious side effects listed, discontinue use and seek medical attention immediately.

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The presence of pubic lice in the eyebrows and eyelashes of children is often a sign of sexual abuse, but children may also catch pubic lice by sharing an infested bed with parents.^{[26]
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