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Information to Live By:
Crabs
What is crabs?
Crabs, or pubic lice, is an infestation of crab-like parasites that
attach themselves to pubic hair and other course hair on the body. While
the scientific name for the parasite is Pthirus pubis and the scientific
name for the condition is Pediculus Pubis, both are referred to
as crabs. Although crabs come from the same family of parasites as head
and body lice, they are not the same thing.
While crabs need blood
to survive, they can live up to 24 hours off a human body.
Crabs have three very
distinct phases:
- The first phase
is the egg, or nit.
- The second phase
is the nymph, or immature form of the adult.
- The third phase
is the louse, or adult crab.
How
common is it?
In the United States, there are an estimated 3 million cases of crabs
every year.
How is Crabs Transmitted?
Sexual
Transmission:
You can
get crabs whenever some part of your body that has coarse hair (such as
the pubic area, eyelashes, eyebrows, facial hair, chest, or armpits) comes
into contact with the infested pubic or other course hair. Crabs do not
usually attach to head hair.
Most cases of crabs
are transmitted through sexual contact, when the crabs move from the pubic
hair of one person to the pubic hair of another. Even when there is no
sexual penetration, you can get crabs or transmit crabs to someone else.
Nonsexual
Transmission:
Nonsexual transmission of crabs is also possible. A person can get crabs
from:
- sleeping in an
infested bed or using infested towels.
- wearing infested
clothing.
- an infested toilet
seat, though this is rare.
What
are the Symptoms of Crabs?
- The most common
symptom of crabs is itching in the pubic area. This itching is caused
by an allergic reaction to the bites, and usually starts about five
days after a person gets crabs.
- Crabs are small
parasites that resemble crabs you see on the beach. They may be whitish-gray
or rust colored. A person may be able to see individual crabs by looking
closely or using a magnifying glass.
- A person may also
notice crab eggs, or nits, attached to the base of the hair (close to
where it comes out of your body). Nits are small, oval-shaped and pearl-like
in color.
- Dark or bluish
spots can appear and last for several days in the infested area; these
are also a result of the bites.
- Crabs are usually
found in the pubic area. However, crabs can also be found in the armpits,
eyelashes, beard/mustache and other course hair. Sometimes, though rarely,
crabs are found in the hair on a person's head.
How
is crabs diagnosed?
- You can usually
see the crabs yourself if you look closely enough. You might need a
magnifying glass to help you identify them.
- If you are uncertain,
have a health care provider examine you. He or she may need to use a
microscope.
How
is crabs treated?
Recommended Treatment
- Permethrin cream:
- The cream can
be applied to the affected area and washed off after 10 minutes.
- Permethrin
is available over the counter.
- Do not use
for treatment of eyelashes or eyebrows.
- Lindane shampoo
(Kwell®)
- This shampoo
that is applied to the affected area and thoroughly washed off after
4 minutes.
- It is available
only by prescription.
- Do not use
for treatment of eyelashes or eyebrows.
- NOTE:
Lindane (Kwell®) is potentially harmful and may cause
central nervous system complications,
even though no problems have been known to occur in treatments
limited to the recommended 4-minute period.
- Lindane
should not be used on broken skin.
- Lindane
is not recommended to be used by the following people:
- women
who are pregnant or lactating
-
children under 2 years of age
-
people with seizure disorders
-
people with extensive dermatitis or known allergies to any
ingredients found in Lindane.
- Pyrethrins with
piperonyl butoxide
- This shampoo
is applied to the affected area and washed off after 10 minutes.
- It is available
over the counter.
- Do not use
for treatment of eyelashes or eyebrows.
- For infested eyelids
and eyebrows an ointment is available by prescription.
Even if treatment
for crabs is successful, you may still have some itching as a result of
a skin irritation or allergic reaction. If so, you can use hydrocortisone
cream to help stop the itching.
What
Else Do I Need to Do to Get Rid of Crabs?
- Even after treatment,
most nits or eggs will remain attached to the hair. Nits can be removed
with fingernails or a fine-tooth comb.
- Wear clean clothing
and sleep between freshly laundered bed linens after treatment.
- Notify sex partners
so that they can be treated.
- Abstain from sex
until treatment is successful and all partners have been treated.
- After you are treated,
your clothes and bedding may still be infested with crabs. To get rid
of them, you will want to wash all your clothes, bed linens, sleeping
bags, etc. in hot water (at least 130-degrees F). Dry on hot cycle for
at least 20 minutes.
- Items that cannot
be washed can be placed in a plastic bag for two weeks or dry-cleaned
to ensure decontamination.
- It is not necessary
to decontaminate furniture or fumigate living areas. If desired, furniture
can be vacuumed or treated with a bug spray containing an agent active
against crabs.
- If after about
a week you still see lice, do the treatment again. Make sure that all
bedding and clothing have been washed and dried on a hot cycle, dry-cleaned
or decontaminated in a plastic bag for two weeks. Also make sure that
that sex partners have been treated.
- Contact your health
care provider if treatment still does not work.
How
can I keep from getting crabs?
- Abstinence (not
having sex) would reduce the risk.
- Mutual monogamy
with an uninfected partner (having sex with only one partner who only
has sex with you) is another way of reducing risk.
- Limiting the number
of sex partners can also reduce risk as it would for all STDs.
- Although latex
condoms do not provide effective protection against crabs, condom use
is effective in preventing other STDs.
Why
worry?
Crabs,
in general, does not cause anything more than discomfort and inconvenience.
Occasionally, secondary bacterial infections may occur due to aggressive
scratching.
Do I need to talk to my partner about crabs?
Yes. Telling a partner can be hard. If you find out you have crabs, it is
important that you talk to your partner as soon as you can so she or he
can get treatment. It is possible to pass crabs back and forth. If you get
treated and your partner doesn't, you may get infected again.
Should I talk to my health care provider about
crabs?
Yes. If you have one STD, you may be at risk for other STDs. You may want
to ask your doctor or nurse about being tested for other STDs.
Where can I get more information?
If you have additional questions about crabs, call the National STD
and AIDS Hotlines at 1-800-342-2437
or 1-800-227-8922. The hotlines are open 24 hours a day, seven days a week.
For information in Spanish call 1-800-344-7432, 8:00 a.m. to 2:00 a.m. Eastern
Time, seven days a week. For the Deaf and Hard-of-Hearing call 1-800-243-7889,
10:00 a.m. to 10:00 p.m. Eastern Time, Monday through Friday. The hotlines
provide referrals and more answers to your questions.
Find
information about other STDs
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