Crabs, also known as pubic lice, are one of the most common sexually transmitted diseases. People all over the world contract crabs, and more than 3 million people are infected with the parasite every year in the United States alone. Genital crabs can be contracted through unprotected sex, sex with multiple partners, and, rarely, through contact with infected bedding, towels, and clothing. Though genital crabs are not a serious health threat, they can cause some uncomfortable symptoms and should be treated as soon as possible.
Diagnosis and Testing
Generally speaking, if you have crabs, you will know about it. Genital crabs are tiny parasites which cause intense itching and are usually visually apparent to the naked eye. If you think you may have crabs, you can do a self-exam of the infected area but it is recommended that you see a doctor just to be sure.
Your doctor will begin the exam by taking your medical history and asking you about your symptoms. In order to diagnose body crabs, your doctor will do a physical exam of your pubic hair, and the hair on your legs, arms, chest, eyebrows, or face. Your doctor will look for any crabs that may be moving about, or for the nits (eggs) that the crabs lay.
Genital crabs are usually white or yellow in appearance, unless they have been feeding, in which case they turn a deep red. Fully-grown crabs are pretty small about the size of a sesame seed and tend to avoid the light. Pubic crabs burrow down towards the skin in order to feed, so your doctor will check for them at the base of your hair.
The nits will also attach to the base of your hair follicles, so it is important to be thorough in your exam. Your doctor may take a sample of your pubic hair in order to analyze the crabs under a microscope. If any nits or crabs are found, you are infected and it is necessary to begin treatment.
Treatment
Treatment of pubic crabs is fairly straightforward and effective. Products are available over-the-counter or by prescription, and typically come in the form of a shampoo. Over-the-counter products contain Pyrethrin (1%) or Pymethrin (1%), while the active ingredient in prescription shampoos is generally Lindane (1%).
In order to treat your crabs, thoroughly wash and dry the infected areas. Apply the shampoo, being sure to saturate your hair. Leave the shampoo on for a few minutes or as indicated on the bottle. Wash the shampoo out and then dry the area, and put on clean clothes. In order to kill all of the genital crabs, you must wash your clothes and linens in hot water and dry them for at least 20 minutes. Any clothes that can’t be washed should be dry cleaned or stored in plastic bags for a few days. Any crabs on these items will die, as they need to return to your body to feed.
If your eyebrows or eyelashes are infected with genital crabs, you should get a special prescription to deal with them. The eye area is particularly sensitive, so you need to be careful to get the right treatment. Generally, your doctor will prescribe a special petroleum-based lotion, which you will apply to your eyelids twice a day for ten days. Before your first application, remove any visible nits or lice with a comb or your fingernails.
If you are pregnant, be sure to tell your doctor as certain medications are contraindicated in pregnant women. The use of Lindane is to be avoided during pregnancy, as it can be absorbed into the body. Instead, your doctor can prescribe a shampoo with the active ingredient Malathion, which won’t be absorbed into the bloodstream and won’t harm your child.
Follow Up
It is important to follow up on your treatment, in order to be sure that you have killed all of the nits and crabs. If your symptoms persist, repeat the shampoo in 7 to 10 days. Be sure to get your partners treated and to abstain from sex until your symptoms disappear. If you notice any severe redness in the infected areas, or any pus, you should return to your doctor for another check-up.