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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. Pubic lice are recognised from the itch and the lice and eggs on the hair, so the doctor confirms the diagnosis by video and photo, directs or prescribes the insecticide and advises on contacts and STI testing; eyelash lice need in-person care.
- What they are: blood-feeding insects, Phthirus pubis, about 2 mm long with crab-like claws built for coarse hair; they cannot jump or fly, crawl from person to person during close contact, live about a month on the body and die within 1 to 2 days away from it.
- Timelines: itching usually begins 5 days to a few weeks after contact as the skin becomes sensitised; eggs hatch in 6 to 10 days, so treatment goes on at day 1 and day 7; itching can linger 1 to 2 weeks after the lice die.
- Treatment: an insecticide lotion or cream such as malathion or permethrin is applied to the whole body from neck to toes, including beard and armpits, left on for 12 hours or overnight, washed off and repeated after 7 days; shaving does not clear pubic lice.
- Contacts: everyone you have had close body contact with in the past 3 months needs checking and, if lice or eggs are found, treating at the same time; bedding, towels and clothes get a 50°C wash or 2 weeks sealed in a bag.
- Emergency: pubic lice are never a 112 emergency; see a doctor in person if scratched skin becomes hot, swollen or weeps pus with fever, or if lice or eggs are on the eyelashes, which need gentler treatment than the usual lotions.
Online care suits typical pubic lice. Book in-person care instead if the skin is spreading red, hot, swollen or oozing pus with fever (a possible secondary infection), or if lice are affecting the eyelashes, which need specific, careful treatment rather than standard lotions. See the referral criteria below before booking.
Can an online doctor treat pubic lice?
Usually, yes. Pubic lice are treated with insecticide lotions applied to the affected hair, and after a video assessment a licensed doctor can confirm the likely diagnosis, advise which treatment to use and how, and prescribe where a prescription product is needed.[1] Eyelash involvement, secondary skin infection or an uncertain diagnosis need in-person care.
On Mobi Doctor, the doctor treats this without any fuss or judgement. Pubic lice are common, they are nobody's fault, and they say nothing about your cleanliness. The consultation also covers the two things people often miss: treating partners, and arranging a check for other sexually transmitted infections.
Listen: Pubic Lice Treatment Online
The audio version of this topic from the Mobi Doctor podcast. Open the episode.
How an online consultation helps with pubic lice
- A discreet, judgement-free assessment: describe your symptoms to a doctor who deals with this routinely, by video from home, with nothing to explain to anyone at a reception desk.
- Exact treatment instructions: which insecticide to use, where to apply it, how long to leave it, and why a second application a week later is what actually clears them.
- Partner treatment and reinfection: the doctor explains who else needs treating and how to avoid passing the lice straight back, so one course is enough.
- An STI check, arranged: pubic lice are usually passed on through sexual contact, so the doctor advises a full sexual-health screen and points you to the right test.
📷 Photos can help: a clear, well-lit close-up of the affected area, taken in daylight, can let the doctor see lice or their eggs (nits) attached to the hair. Photos are optional and you can upload them securely when booking, but the consultation works without them.
What are pubic lice, and how do you get them?
Pubic lice (Phthirus pubis), often called crabs, are tiny insects that live on coarse body hair and feed on blood, causing itch. They are most common in pubic hair but can also affect hair on the abdomen, chest, thighs, underarms, beard and, occasionally, the eyelashes and eyebrows.[2] They are different from head lice and cannot be caught from a toilet seat in any usual sense; they need close contact to spread.
Pubic lice are passed on mainly through sexual or close bodily contact, and sometimes through shared bedding, towels or clothing. Because they are spread this way, having pubic lice is a reason to check for other sexually transmitted infections at the same time, which the doctor will advise on. The main symptom is itching in the affected area, often worse at night, and you may notice the lice themselves, pale eggs glued to the hair near the skin, or tiny dark spots of louse droppings on the skin or underwear. Some people also see small blue-grey marks where the lice have fed.[1]
How do you treat pubic lice?
Pubic lice are treated with an insecticide lotion or cream, such as permethrin or malathion, or a physical agent such as dimeticone, applied to the affected areas and repeated after about a week.[1][3] Applied correctly, treatment is highly effective. The steps that matter:
- Apply the treatment to all affected coarse body hair, not just the pubic area: this can include the abdomen, thighs, chest, underarms and, in men, the beard. Lice can live anywhere there is coarse hair.
- Leave it on for the full time stated in the product instructions (some are washed off after a set number of hours, others left overnight), then wash off.
- Repeat the whole application after about seven days. This second treatment catches lice that hatch from eggs the first application does not kill, and skipping it is the commonest reason treatment seems to "fail".[5]
- Wash clothing, towels and bedding used in the previous few days at a hot temperature, or seal them in a bag for a few days, to avoid reinfection.
- Treat all current sexual partners at the same time, even if they have no symptoms, so the lice are not simply passed back.
You do not need to shave off your hair to get rid of pubic lice; the treatment does the work. Itching can persist for a short while after successful treatment because the skin is still reacting, which does not mean the treatment has failed, but new eggs or moving lice after two correct courses do warrant a fresh look.
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| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Typical itch with visible lice or eggs in pubic or body hair, otherwise well | Insecticide lotion to all affected hair, repeated after 7 days; treat partners | Usually yes | Diagnosis uncertain, or lice persist after two correct courses |
| Eyelash or eyebrow involvement | Specific, gentle eyelash treatment (standard insecticides are not used near the eyes) | Case-dependent | Eyelash infestation needs careful in-person guidance |
| Already treated, still itching or seeing lice | Review application technique and reinfection; consider an alternative agent | Usually yes | Persistent live lice after two correctly applied courses |
| Spreading redness, pus, or fever (possible secondary skin infection) | In-person assessment; treatment of the skin infection | No | Prompt face-to-face care |
Not sure which row is you? A doctor can tell you in one consultation.
See available times →Should I get an STI check if I have pubic lice?
Yes. Because pubic lice are usually passed on through sexual contact, having them is a sensible prompt to test for other sexually transmitted infections, even when you feel completely well.[2][4] Many of these infections cause no symptoms, so a full screen is the only way to know.
The doctor will advise which tests make sense for you and where to get them, and can point you to the relevant pages, including chlamydia, gonorrhoea, syphilis and HIV testing. This is routine advice offered to anyone with pubic lice, not a judgement about you, and testing after any new or unprotected contact is simply good sexual-health practice.
When it might be something else
Itching in the genital area has several causes, and part of the consultation is checking you are treating the right one. Intense itch that is worse at night, with a fine rash and burrow lines in the finger webs, wrists or genitals, points to scabies rather than pubic lice, and scabies needs a different treatment applied to the whole body. Itchy, inflamed bumps around hair follicles after shaving can be folliculitis. Redness, soreness or discharge may point to thrush or another infection instead. If you cannot see lice or eggs and are not sure, that uncertainty is exactly what the doctor helps resolve, rather than treating blind.
What the doctor checks in an online pubic lice consultation
The assessment is quick but structured. In a pubic lice consultation, the doctor will typically check:
- Your symptoms and their pattern: where you itch, for how long, and whether it is worse at night.
- What you can see: lice, eggs glued to the hair, or dark droppings, from your description or an optional photo.
- Which areas are affected: pubic hair only, or also the abdomen, thighs, chest, underarms, beard, or eyelashes, because that changes the treatment.
- Signs of secondary infection: spreading redness, pus or fever from scratching, which need in-person care.
- Partners and exposure: who else may need treating, so reinfection is avoided.
- Whether an STI screen is due, and any pregnancy or breastfeeding, which affects the choice of product.
How do I tell my partner about pubic lice?
Be straightforward: pubic lice are common, easily treated, and not a sign that anyone did anything wrong. Current partners should be treated at the same time as you, whether or not they itch, because untreated partners simply pass the lice back. It is also worth telling recent partners so they can check and treat.
A workable line is: "I've been treated for pubic lice. They're common and easy to sort out, but you should treat yourself too so we don't pass them back and forth." Because lice can be present for a while before they itch, their appearance does not reliably tell you when or from whom they were picked up, so it is rarely worth turning into a question of blame.
When pubic lice are treated online, and when you need in-person care
Treated online: typical pubic lice with a clear history or visible lice or eggs; advice on correct application and the essential second treatment; partner treatment; and guidance on a full sexual-health screen, which is part of dealing with pubic lice properly. The same consultation can steer you towards wider STI testing and treatment where that is sensible.
In-person care: lice affecting the eyelashes, which need specific in-person treatment near the eyes; signs of a secondary skin infection from scratching; an uncertain diagnosis where the itch may be scabies or another skin condition; and cases that persist despite two correctly applied courses. In those situations the consultation still gives you a clear plan and the right next step rather than another lotion that will not help.
When to get in-person care
Pubic lice are not dangerous, but scratched skin can become infected. Seek in-person care if the skin becomes spreading red, hot, swollen or weepy with pus, especially with a fever, which can indicate a bacterial skin infection needing antibiotics. If you ever develop a rapidly spreading infection with a high fever and feel very unwell, or signs of a serious allergic reaction to a treatment such as swelling of the face or throat or difficulty breathing, call 112 immediately.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, exact price up front.
- Speak to a licensed doctor about pubic lice: a private video call: you describe what you feel, the doctor asks what matters, and you agree the right plan together.
- Get your treatment plan: any prescription the doctor decides is right, plus clear advice on partners and STI testing; if your doctor decides you need to be seen in person, you get a full refund.
No sign-up needed
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Frequently asked questions about pubic lice
What are pubic lice, and how do you get them?
Pubic lice are small blood-feeding insects, about 2 mm long, that grip coarse body hair with crab-like claws, hence the nickname crabs. You get pubic lice through close body contact, almost always sexual, with someone who has them; they cannot jump or fly, so they crawl across during skin contact, and catching them from bedding, towels or clothes is rare. Condoms do not prevent them, and they are not a sign of poor hygiene.
What are the symptoms of pubic lice?
Pubic lice cause itching in the pubic area, and sometimes the chest, armpits, beard or eyelashes, that is worse at night and starts days to weeks after contact; tiny red or blue-grey spots where the lice have fed; white or yellow eggs (nits) glued to the base of hairs; dark red or brown specks of louse droppings in underwear; and, with a magnifying glass, the grey-brown lice themselves, which are hard to spot.
Can an online doctor treat pubic lice in Europe?
Yes, in most cases. After a video consultation, with a clear photo if you are comfortable sharing one, the doctor confirms that pubic lice are the likely cause, explains which insecticide to use and exactly how to apply and repeat it, prescribes where a prescription product is needed, with the prescription usable at a pharmacy near you, and advises on partners and STI testing. A prescription is never issued without a consultation.
Do I need to shave off my pubic hair to get rid of pubic lice?
No. Shaving does not clear pubic lice, because lice and eggs on the chest, armpits, beard or thighs survive, and shaved skin stings badly under the lotion. The insecticide kills lice and eggs on every hair it reaches, which is why it goes on the whole body from the neck down rather than the pubic area alone, and is repeated after seven days to catch anything that hatched in between.
Why do I need to treat pubic lice twice?
Because insecticides kill live pubic lice reliably but not every egg, and eggs hatch over six to ten days. A second application seven days after the first kills the newly hatched lice before they are old enough to lay eggs of their own, which breaks the cycle. Skipping the second application is the commonest reason pubic lice seem to come back; the other is a partner who was not treated at the same time.
Should my partner be treated for pubic lice too?
Yes. Current partners should be checked and treated at the same time as you, whether or not they itch, so that pubic lice are not passed straight back; anyone you have had close body contact with in the past three months should be told so they can check. Avoid close body contact until both of you have completed both applications. Telling people is easier than it sounds, because pubic lice are common and easily cleared.
Do pubic lice mean I have another STI?
Not necessarily, but because pubic lice are nearly always passed on during sex, people who have them are more likely to have another sexually transmitted infection, and many STIs cause no symptoms. A test for chlamydia, gonorrhoea, syphilis and HIV at the same time is sensible; the doctor advises which tests you need and where to get them where you live.
How long do pubic lice take to clear?
With the lotion applied correctly on day one and day seven, pubic lice are gone within about a week of the second treatment. Itching can carry on for one to two weeks after the lice are dead because the skin is still reacting to their bites, and empty egg cases stay glued to hairs until they grow out. Live lice or new eggs a week after the second application mean reinfestation or treatment failure.
Do I need to wash my bedding and clothes if I have pubic lice?
Yes, on the day of the first treatment. Pubic lice die within one to two days away from the body, but eggs can survive longer, so wash bedding, towels and clothes worn in the previous few days at 50°C or hotter, tumble-dry on hot, dry-clean, or seal them in a plastic bag for two weeks; vacuum the mattress. Fumigating the home is unnecessary, and pets do not carry pubic lice.
What can I do at home to get rid of pubic lice?
Apply the insecticide to clean, dry, cool skin over the whole body except the eyelashes, including beard, chest, armpits, thighs and buttocks, leave it for 12 hours or overnight, wash it off and repeat after seven days; wash bedding and clothes; avoid close contact until everyone is treated; comb out dead pubic lice and nits with a fine comb; and do not treat more often than directed, because itch after treatment is not failure.
How can I prevent pubic lice?
Prevent pubic lice by avoiding close body contact with someone who has them until they have completed treatment, not sharing bedding, towels or clothing with them in the meantime, and checking yourself if a partner is diagnosed. Condoms do not protect against pubic lice because the lice live on hair outside the covered area, and shaving does not prevent them. There is no lasting immunity, so reinfestation is possible.
Are pubic lice treated differently on the eyelashes or in pregnancy?
Yes. Pubic lice on the eyelashes are never treated with the body lotions; petroleum jelly applied thickly twice a day for about 10 days smothers them, and lice and eggs are picked off with tweezers, under a doctor's guidance. In pregnancy and breastfeeding, permethrin is the usual choice and malathion is kept for when nothing else suits; the doctor confirms which. Pubic lice in a child need in-person assessment.
Is it pubic lice or something else?
Genital itching has other common causes: scabies (burrows and itching between the fingers and on the wrists as well), thrush (itch with a thick discharge), eczema or contact dermatitis from products, folliculitis (pimples on hairs after shaving) and dry skin. Seeing eggs glued to hairs, the tiny lice themselves or blue-grey bite spots confirms pubic lice, and a photo lets the doctor tell the difference.
- Pubic lice: clinical knowledge summary, NICE CKS, National Institute for Health and Care Excellence, reviewed 2024.
- European guidelines on the management of sexually transmitted infections (ectoparasites), IUSTI Europe (International Union against Sexually Transmitted Infections), 2022.
- Pubic lice (Phthirus pubis), DermNet New Zealand Trust, reviewed 2023.
- Sexually transmitted infections (STIs) fact sheet, WHO, World Health Organization, 2025.
- Pubic lice (crabs), HSE, Health Service Executive (Ireland), accessed August 2026.
- Pubic lice, NHS, National Health Service (UK), reviewed May 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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