Crabs (Pubic Lice): Symptoms, Treatment, and How to Get Rid of Them Fast

You noticed the itching a few days ago. Maybe it started after a big night out, maybe you have been in Pattaya for a week and you are only just putting the pieces together. You are Googling symptoms at 11pm and wondering how bad this actually is. Take a breath. Pubic lice are one of the most treatable things we see here. This is not a crisis. It is a parasite, and it has a straightforward fix.

Most cases respond well to an over-the-counter treatment you can pick up at a Thai pharmacy. The whole process takes about two weeks from start to finish. That said, there are situations where a doctor visit makes sense, and we will walk through all of them. If you want to skip the pharmacy guesswork and get sorted today, Doctor Pattaya is open around the clock with no appointment needed.

What Are Pubic Lice and How Do You Spot Them

Pubic lice are tiny parasites that live in coarse body hair. They are not the same as head lice. They are smaller, crab-shaped, and they move much more slowly. You might actually see one clinging to a hair shaft if you look closely, though most people notice the itching long before they spot anything.

The eggs, called nits, attach firmly to the base of hair shafts and look like tiny pale dots. They do not brush off the way dandruff does. Adult lice are greyish-brown and about the size of a sesame seed.

Itching usually starts about five days after exposure and is often worst at night. You may also notice small dark spots on your underwear from lice droppings, or tiny red or bluish spots on the skin where lice have fed.

How Pubic Lice Spread — and It Is Not Always Sexual

Sexual contact is the most common route. Pubic lice spread through close physical contact between bodies, and in adults, this usually means sex. But not always.

Shared towels, bedding, or clothing can transfer lice, especially if the exposure is recent. Lice cannot jump or fly, but they can survive off the body for up to 24 hours. Staying in a hotel where bedding was not properly changed between guests is a real, if less common, way to pick them up. We do see tourists in Pattaya who are genuinely surprised, because they have not had new sexual partners. It happens.

Public toilets, swimming pools, and casual contact do not transmit pubic lice. The parasite needs close, prolonged contact with warm skin and hair to transfer.

Where Else Pubic Lice Can Spread on the Body

The name is slightly misleading. Pubic lice prefer coarse genital and perianal hair, but they can spread to the thighs, abdomen, armpits, chest, beard, and eyebrows. Eyelash infestations are less common but do happen, and this is where self-treatment gets tricky.

You should never apply standard lice treatments near the eyes. Eyelash lice require a different approach, typically petroleum jelly applied carefully twice a day for about a week. If you are dealing with lice near the eyes, come in and see us rather than trying to manage it yourself. Getting it wrong in that area is not worth the risk.

How to Treat Pubic Lice at Home — Step by Step

Most cases start with an over-the-counter product. In Thailand, permethrin 1% cream rinse and pyrethrin-based shampoos are available at pharmacies without a prescription.

Apply the product to all affected hair areas, not just the groin. Include thighs, lower abdomen, armpits, and any other body hair where you have noticed itching or lice. Leave it on for the time stated on the packaging, usually around ten minutes, then rinse thoroughly. Use a fine-toothed nit comb while hair is still wet to remove dead lice and nits. Repeat the entire treatment seven to ten days later to catch any eggs that hatched after the first round.

For your environment: wash any clothing, bedding, or towels used in the last 48 hours at 60 degrees Celsius. If you are in a hotel without laundry access, seal items in a plastic bag for 72 hours. Most hotels along Beach Road, Jomtien, and Pratumnak handle laundry quickly and without needing a detailed explanation from you.

Do not have sex until both you and any partners have completed treatment and confirmed clearance.

When Pharmacy Treatment Does Not Work — What a Doctor Can Prescribe

If you have done two rounds correctly and you are still finding live lice, you need a prescription option. Resistance to permethrin has been documented in some lice populations, and in those cases a different drug is needed.

Ivermectin, taken as a single oral dose and repeated after a week, works well where topical treatments have not. Malathion lotion is another option for resistant cases. Both require a prescription in Thailand. Dosing matters, and the right choice depends on your situation, so do not try to source either outside a clinic.

This is exactly where a walk-in visit to Doctor Pattaya makes sense. You come in, we confirm the diagnosis, we prescribe the right treatment on the spot, and you leave with everything you need. If you have already spent a week on pharmacy products with no result, do not spend another week wondering. Come in.

Pubic Lice and STD Screening — Why It Is Worth Doing at the Same Visit

Pubic lice do not transmit HIV, chlamydia, gonorrhoea, or other infections. The lice themselves are not an STD in that sense. But having them means the physical contact that spreads other STDs was also present.

Standard guidance recommends STD screening for anyone confirmed to have pubic lice. I bring this up with every patient who comes in for crabs, especially tourists and expats who may not have had routine testing recently. Finding pubic lice is often the nudge that turns up something else that was sitting undetected.

A full STD screen at the same visit covers chlamydia, gonorrhoea, syphilis, HIV, and hepatitis B. Our STD treatment service in Pattaya handles all of this in one appointment, with most results back within 24 to 48 hours. You do not need to come back on a separate day.

What Happens If You Leave Pubic Lice Untreated

Mostly more itching, and progressively worse itching at that. Constant scratching breaks the skin, and broken skin in the genital area is vulnerable to secondary bacterial infection that may need antibiotics.

Prolonged infestation also means ongoing spread to partners, to other hair-bearing areas of your own body, and to anyone sharing your bedding. What starts as a manageable two-week fix becomes a longer, more complicated problem. Treat it now. It is genuinely easier.

Getting Treated for Pubic Lice in Pattaya

Whether you are three days into a holiday, a long-term expat who has been putting this off, or someone staying in Jomtien who found us through a hotel recommendation, the process here is simple. You walk in, you see a doctor, no waiting weeks for an appointment.

The consultation at Doctor Pattaya is private and without judgement. We see this regularly, and we are not going to make you feel awkward about it. We confirm the diagnosis, sort out whether OTC or prescription treatment fits your situation, and run a full STD screen at the same visit if you want it.

If you cannot get to the clinic, our doctors can visit you at your hotel across Pattaya, Jomtien, Naklua, and Pratumnak.

Partner notification is something we can also talk through during your visit. If the partner is someone you are still in contact with, they need to be treated at the same time or reinfestation is almost certain. If it was a short-term contact during your trip, we can help you work out how to handle that too.