Killing Crabsby The HealthCentral Editorial Team
You tell yourself it's just an itch. Some prolonged jock itch, or a little rash -- nothing a little soap and water can't cure, right? But soap and water doesn't seem to be doing the trick. In a week or so, what was once a little itch has become a full-fledged burn. And you've caught your partner or roommate sneaking a hand down the pants, too.
Crabs? Couldn't be. When it comes to life's little embarrassments, a little denial can go a long way. A simple problem with a simple solution can become a mini-epidemic of pretty nasty proportions. Sure, the idea of some little critters frolicking in your pubic jungle, digging in for a drink of blood now and then, isn't exactly something to put on a resume, but it's nothing to be ashamed of. And the longer you ignore the problem, the more unnecessary discomfort you'll have to endure.
While crabs, known to the stethoscope set as Phthirus pubis, differ slightly from the species of lice that inhabit other parts of the body, they are, for all intents and purposes, very similar and are treated in exactly the same way. Says Michael Burnhill, M.D., the medical director of Planned Parenthood in New York City, NY, "Head lice, crabs -- it's all the same thing: you shampoo, you wash your clothes, you're done."
Crab Central In cramped, communal living situations such as college dorms, shared summer rentals, or spring break hotel rooms, the crab population can rival that of the Chesapeake Bay. In these settings, eliminating crabs for good can be a real challenge.
According to Burnhill, pubic lice are almost invariably transmitted from person to person during sexual activity, but when infested pubic hair detaches, lice can hatch on underwear, on towels, in beds, on toilets -- anywhere that comes face to face with your special place. As long as the temperature is 50 degrees or higher, a borrowed towel or a nap in a neighbor's bed could leave you itching.
Step one is to admit the problem -- the sooner the better. That itch could very well be something else, but at least face the possibility of crabs. Diagnosis is a no-brainer if you spot the little crawly guys in your pubes. Complicating the process for do-it-yourselfers, full-grown crabs are about half the size of head lice, lay fewer eggs, and are light colored; therefore, can be relatively hard to detect. Also look for "nits," which are eggs firmly attached to the hair shafts, as well as red bite marks or hives in the genital area. You might also notice some strange spots in your underwear.
Once you've determined there's a whole ecosystem in your knickers, you have to resolve to eliminate the problem. The good news is that, except in the most extreme cases, you won't have to visit a doctor or get a prescription -- but you will have to alert sexual partners, roommates, and anyone else who might be privy to your unwanted guests. Remember those head checks in elementary school? Same deal here, minus the gym teacher: one infested apple can spoil the whole bunch.
Getting Rid of Unwanted Guests in Your Pubes Burnhill explains that in the vast majority of cases, an over-the-counter de-lousing shampoo like RID or the prescription medicine Kwell will do the trick. It's important to follow the instructions on the box very closely, as crabs are tenacious fellows and are developing an immunity to some of the shampoos on the market. It's also important to note that these shampoos aren't exactly of the wash-rinse-repeat variety. They are highly toxic and should not be used more often than recommended or around inflamed areas or near the eyes. Pregnant women should also seek alternative avenues. After shampooing, you should use a "nit comb" (a fine-toothed comb used to remove any remaining nits from the pubic hair).
Keep in mind that while shampooing is an easy, effective way to banish the cooties from your body, if you don't take care of the ones in your clothes and bedding as well, a new crab colony could be established in no time. Dump your dirty clothes and your bedding in the washer, and then dry them on a hot setting to get rid of any stragglers. Nonwashable items can either be dry-cleaned or, if you'd rather the crabs die a slow death, sealed in a plastic bag for 10 days. Finally, spray some disinfectant (Lysol will do) on any furniture that might be at risk for crab contamination.
Even after a full-frontal assault on the enemy, it's not uncommon for crabs to return to the scene of the crime. If that's the case, you'll just have to repeat the process until they're gone. A half-assed approach, however, or one in which you don't communicate with those around you, is almost certain to fail. Crabs aren't dangerous: embarrassing, maybe; uncomfortable, undoubtedly; but the biggest risk you face (other than explaining to your sexual partner why you've suddenly taken up ironing) is scratching yourself so hard that you end up with an infection.
"There's no good reason to let it get that far," explains Burnhill. A case of crabs may not exactly be a day at the beach, but it doesn't have to be a living hell, either. And just think how clean your place will look once they're gone.