What Are Effective Pubic Lice Treatment Home Remedies?

Creepy crawlies on your genitals—what to do?

While natural remedies are typically less effective than over-the-counter and prescription treatments, several options may still help halt a pubic lice infestation in its tracks.

What are pubic lice and crabs?

Pubic lice—known colloquially as “crabs”—are small (less than 2mm), crab-resembling insects that infest the genital area. They’re typically spread by sexual contact, although wearing clothes or sleeping in linens used by an infected person can also share the insects. The most common symptom is severe genital itching, caused by bites.

Pubic lice can also spread to other body hair, including in the armpits or on the face.

Aside from being seriously annoying and uncomfortable, a pubic lice infestation—also known as phthiriasis—can result in skin discolorations (pale blue spots), secondary infections from irritating bites as well as conjunctivitis if it spreads to eyelashes. Having sex with multiple partners increases your risk of contracting pubic lice.

How do you diagnosis and treat pubic lice or crabs?

Typically, you’ll have a pretty clear idea it's pubic lice when you see small, crab-shaped bugs crawling in your pubic hair—and that’ll be more than enough to warrant immediate treatment.

Visual confirmation of eggs—also known as nits—also gives away the presence of pubic lice, although finding nits after treatment doesn’t necessarily mean it was unsuccessful, as eggs can cling to pubic hairs long after lice have been killed.

Though pubic lice are different than head and body lice, the treatment to get rid of pubic lice is similar: over-the-counter (OTC) lotions and shampoos containing 1% permethrin (you may know the brand name, Nix) that kill both lice and eggs is a good place to start.

An OTC mousse with pyrethrins and piperonyl butoxide works, too. Prescribed medications such as the lotion Malathion and the topical/oral medication Ivermectin may also be options if OTC methods are unsuccessful.

Even after treating the infected areas, it’s essential to make sure there are no lingering pubic lice on hairy areas such as legs, chest and arms; these locations may require topical treatment. Just make a note: Shaving doesn’t treat pubic lice, although trimming hair can make treatment easier.

Pregnant women should consult their doctor about treatment, as not all medications are safe when there’s a baby on board. Permethrin cream is safe for use during pregnancy, but be sure to wash it off carefully before breastfeeding and reapply afterward.

Individuals with open scratches or wounds should check with their doctor before using topical treatments at home.

How can you naturally treat pubic lice at home?

If you’d rather avoid medications or don’t have time or resources to obtain any, it’s possible to get rid of pubic lice naturally.

Natural remedies require diligence and effort and aren’t recommended as the first line of treatment, as they may lead to community spread. However, if you've run your intentions by your doctor, natural treatments can be tried on their own or in combination with medications.

Various oils are the best-studied natural remedies that show promise. A 2018 study indicated that anise oil and olive oil could effectively coat, suffocate and eliminate head lice and may work best when used in tandem.

A 2010 study reported coconut oil killed 80 percent of head lice in three hours, compared to 97.9 percent killed by the most effective lice shampoo. Petroleum jelly is messy, but it may be effective in suffocating lice and can be a great option for sensitive areas such as around the eyes. Other natural remedies (lemon juice, witch hazel, apple cider vinegar) can help reduce irritation caused by bites.

Keep in mind, however, the safety and effectiveness of natural treatments on pubic lice vary and are not well-documented, as most studies have focused only on head lice. Pubic lice are similar but not exactly the same as head lice—they're smaller for a start. But what kills head lice will probably do the same for pubic lice, so if you've had good experiences with these natural remedies, go for it.

Regardless of how you decide to treat public lice, it’s essential that all bedding, clothing and other potentially infested items are washed on high heat—at least 130 degrees Fahrenheit—and dried on high heat for at least 20 minutes. Delicate items should be stored in an airtight bag for two weeks to kill pubic lice.

How can you keep pubic lice at bay?

Don’t have sex or share clothes, bedding or towels with someone who has pubic lice.

If you contract pubic lice, make sure you are fully treated and louse-free before having sex again and make sure you inform any of your sexual partners that may have been infected so they can get treated, too. It may be embarrassing, but they'll thank you.​