Anonymous on August 9, 2011

How do I get rid of crabs?

I’m a 20-year-old questioning my sexual orientation. I recently had sex with a guy and got crabs. I bought Kewllada, washed myself as instructed and followed up with a fine tooth comb. I soaked my clothes, sheets and quilts in hot water and dried them. I also scrubbed my room. Three days later, I washed with the lice cream again, and repeated that again four days later. Now I have crabs again even though I have not been sexually active. I’ve washed everything four times and I can’t get rid of them! Please help!

answered by Lisa Oldson, MD on August 9, 2011

Thanks for your question. I’m sorry that you’re having a rough time...I’ll try to help you understand what crabs are and offer you some ideas for getting rid of them. For more specific and personalized suggestions, I encourage you to call your doctor.  

Starting with the basics, “crabs” are pubic named because under a microscope the adult lice look a bit like a crab. With the naked eye, they’re hard to spot...they look like small flakes of skin. These small, parasitic insects thrive in pubic hair and other coarse hair on the body like eyebrows, mustaches and underarm hair. If you’ve found a crab louse or an egg (called a “nit”) attached to hair in your pubic region, you probably have pubic lice...and you’re on the right path by using a treatment shampoo and washing your clothes in hot water.

Crabs can be treated and cured with a combination of medicated creams and shampoos, as well as careful washing and drying of clothing and other linens. It sounds like you’re doing the right things, but these tips for getting rid of crabs might also help:
    Wash clothing and bedding first. Before you start treatment, clothing and bedding should be washed in hot water that is at least 130º F and dried at the highest drier temperature. If you have clothing or bedding that you can’t wash, they can be dry-cleaned or you can put them in a plastic bag and seal it tightly for two weeks.
    Find the right treatment. The shampoo you used, Kewllada, contains a drug called “lindane” thataccording to treatment guidelines from the Centers for Disease Control and Prevention (CDC) is no longer the first line treatment of pubic lice. I suggest contact your regular doctor for more current treatment options that are most appropriate for your specific symptoms.
    Apply treatment to the affected areas. When you apply the treatment cream or mousse, your skin should be cool and dry so that it doesn’t absorb the chemicals in the treatment. Apply the treatment to the skin and hair in the pubic area and around the anus, but you should not apply it inside the vagina or rectum. Make sure to apply the lotion or mousse to all hairy areas such as legs, underarms, chest, back and thighs. The CDC recommends that you apply the treatment to all of the affected areas and then wash it off after 10 minutes.
    Remove nits. After treatment, the nits (eggs) will likely still be attached to the hair shafts and you have to remove all of these with a fine-toothed comb, tweezers or fingernails. When you’re done, make sure to put on clean clothing.
    If needed, reapply one week later. If you still have itching 7-10 days after the treatment, you may need another application. But if this happens, talk to your doctor to make sure you don’t have something else....there are a few diseases that look a little like crabs but need a different treatment.

Talk to your doctor about getting tested for other STDs, too. Because you’ve been exposed to pubic lice, there is a possibility that you’ve been exposed to other STDs, as well...including chlamydia, gonorrhea, herpes, hepatitis B and C, HIV and syphilis. In one study, 31% of people with pubic lice also had another STD, so getting tested may be a smart and important step for you.

Getting tested is quick and easy. And knowing your STD status will give you peace of mind and keep you from developing potential serious health problems down the road resulting from an untreated sexually transmitted infection.

Finally, be sure to inform your recent sexual partner or partners about your STD status so they can get tested and treated, if necessary too. And be sure to practice safer sex by using condoms and dental dams each and every time you have vaginal, anal or oral sex.

For more information about preventing STDs, and STD symptoms, complications, testing and treatment, take a look at our Expert Guide to STD Basics.

Thanks for writing...your question will surely help other people, too. I wish you the best of health.

Related info:

Lisa Oldson, MD

Dr. Oldson is Medical Director of the Analyte Physicians Group. She is on staff at Northwestern Memorial Hospital, as well as Clinical Instructor at the Feinberg School of Medicine, Northwestern University. Her areas of expertise include STDs (with a particular clinical emphasis on herpes), women's health, preventive medicine, diabetes, obesity and weight management, and mood and anxiety disorders. Dr. Oldson was educated at Rush Medical College and completed her residency at Rush-Presbyterian-St. Luke's Medical Center in Chicago, IL.

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