Yes, pubic lice (often called “crabs”) are completely curable. Most infestations clear up with a single round of over-the-counter treatment, and even resistant cases respond well to prescription options. Pubic lice don’t burrow into your skin or cause lasting damage, and once the lice and their eggs are eliminated, the infestation is over.
How Treatment Works
The standard treatment is a topical insecticidal wash, typically containing permethrin or pyrethrins with piperonyl butoxide. These are available without a prescription at most pharmacies. You apply the product to the affected area, leave it on for the recommended time (usually around 10 minutes), then rinse it off. That single application kills the live lice.
Because the treatment may not destroy all eggs (called nits), a second application is typically needed 7 to 10 days later. This catches any lice that hatched after the first round. Between treatments, you can use a fine-toothed nit comb to remove visible eggs attached to hair shafts.
When First-Line Treatment Doesn’t Work
In some cases, lice are resistant to over-the-counter products. If the infestation persists after two proper applications, prescription options are available. A lotion containing malathion can be applied to the affected area and washed off after 8 to 12 hours. This is specifically recommended when treatment failure is believed to result from resistance.
An oral medication (ivermectin) is another alternative. It’s taken by mouth with food to improve absorption, then repeated 7 to 14 days later. Because it works systemically rather than topically, it can reach lice in areas that are harder to treat with a cream or lotion, such as coarse body hair on the chest or thighs.
What About Shaving?
Removing body hair eliminates the habitat pubic lice need to survive, since they cling to coarse hair shafts and lay eggs there. Shaving can help, but it’s not considered a standalone cure because lice or eggs may remain on other body hair or on bedding and clothing. Chemical treatment is still the recommended approach. Shaving can be used alongside it if you prefer.
Cleaning Your Environment
Lice can survive off the body for one to two days, so cleaning your surroundings prevents reinfestation. Wash all bedding, clothing, and towels you used in the two to three days before treatment. Use hot, soapy water at a minimum of 130°F (54°C), then run items through the dryer on the hottest setting for at least 20 minutes. Items that can’t be washed can be sealed in a plastic bag for two weeks, which starves any remaining lice and eggs.
Furniture and mattresses don’t need special treatment. Pubic lice can’t survive long without a human host, and they don’t infest homes the way bed bugs do.
Treating Sexual Partners
Pubic lice spread primarily through close body contact, so any sexual partners from the previous month should be notified and treated at the same time. If only one person is treated, the lice simply pass back and forth. Both partners need to complete treatment before resuming skin-to-skin contact.
Are There Lasting Health Effects?
Pubic lice do not transmit disease. The main risk from an untreated infestation is skin damage from scratching. Intense, prolonged scratching can break the skin and lead to a secondary bacterial infection, which may need antibiotics. But the lice themselves cause no long-term harm. Once treated, the itching typically fades within a few days as the skin heals, though mild irritation can linger for up to a week or two after the lice are gone.
There’s no immunity after an infestation, so reinfection is possible if you’re exposed again. But each new case is just as treatable as the first.