Head, Pubic, and Body Lice: Pictures, Treatment, and Prevention

Even just the word "lice" is enough to send most people into a hair-checking frenzy. Causing outbreaks in school classrooms and households, a lice infestation can require significant time, effort, and resources to get under control. Though we think of lice as a children's problem, these parasitic insects can affect adults as well as children. They can be found on people's heads and bodies, including the pubic area. According to dermatologists, here's everything you need to know about lice, including symptoms and lice treatments.

What Exactly Are Lice?

Bad news: Lice are actually tiny parasitic insects that can be found on your head, pubic hair, and body. Even though they are slightly different, they all have one mission: to live on your body and feed on your blood (they need it to survive), according to the Centers for Disease Control and Prevention (CDC).

All types of lice have three forms: nits, which are lice eggs; nymphs, which are immature lice; and adult lice, which are fully grown and about the size of a sesame seed. But even different types of lice—head, pubic, and body—look slightly different from each other, Joshua Zeichner, MD, a dermatologist at The Mount Sinai Hospital, told Health.

Head Lice

Head lice, which are actually called Pediculus humanus capitis, are tall and thin, and they attach themselves to the hair shafts on your head, Dr. Zeichner said.

According to the CDC, in the United States, infestation with head lice is most common among preschool children attending childcare, elementary school children, and the household members of infested children. Up to 12 million infestations happen each year in the US among children 3 to 11 years old.

Body Lice

Body lice, aka Pediculus humanus corporis, are similar in shape to head lice but attach to the fabric of clothing and then travel back and forth to your skin to feed on you.

Pubic Lice

Pubic lice, which are also called Pthirus pubis, are short and squatty—sometimes called "crabs" because of their shape—and attach to coarse hair on your body. This includes pubic hair but also facial hair, eyebrows, eyelashes, and armpits.

Symptoms of Lice

As far as symptoms go, they're pretty much the same for all types of lice: Itching and mild skin irritation because of the itching, Rajani Katta, MD, a dermatologist at Houston Methodist, told Health. Itching should be avoided when possible because it can increase the risk of getting a bacterial infection.

The CDC also points out that you may see small bite marks or sores, and sometimes a rash breaks out as an allergic reaction to bites from body lice. Whether you're dealing with head, body, or pubic lice, you will also be able to see them, nits and all.

So, How Do You Get Them?

According to Dr. Zeichner, all forms of lice are contracted through direct or intimate contact. (So not usually not by shaking hands with someone in passing.) Beyond that, how you contract lice depends on the kind of lice you're talking about.

Head lice, for example, are transmitted pretty easily through shared clothing, hats, hairbrushes, or bedding. Kids are ripe targets for head lice because of their close proximity to one another in classrooms and daycares, but, Dr. Katta said, it's important to remember that having head lice is not a sign of bad hygiene or dirtiness; spreading head lice can be as simple as sharing a hair elastic or beanie among friends.

With body lice, it's a little different. The CDC says body lice are generally found on people who live under crowded conditions with poor hygiene. Body lice are spread through direct contact with an affected person or through contact with clothing or bedding that a person with body lice has used. Not being able to bathe regularly or having changes in clean clothes can increase the risk of getting body lice.

Pubic lice, on the other hand, are a sexually transmitted infection (STI), meaning you get them from sexual contact with an infected person. You could also get from undergarments, bath towels, bedding, or a toilet seat, but it's very rare for this to happen, says the CDC.

Because pubic lice are sexually transmitted, they are most common in adults, according to the CDC. Finding pubic lice anywhere on a child's body—even if it's just their eyelashes—could be a sign of sexual exposure or abuse. These cases should be addressed immediately.

Treatment

Generally, all lice are treated in the same way: with a topical prescription or over-the-counter (OTC) medication. A medicine that can kill lice is called a pediculicide. It is used at least twice—once to kill the adults and a second time, several days later, to kill any nits that have hatched since the first treatment.

The medication for head lice should be applied according to the instructions, per the CDC. You can also comb any of the dead or dying lice out of your hair with a fine-toothed comb, Dr. Katta said.

For pubic lice, lice-killing lotions that contain active ingredients called permethrin, pyrethrins, or piperonyl butoxide, can be applied to the area, according to the CDC. Dead or dying lice, again, can be removed with a fine-toothed comb or your fingernails.

As a reminder: With pubic lice, you should warn all sexual partners from the previous month that they're at risk for infection; and it's a good idea to abstain from sexual contact until you're given the all-clear (pubic lice can clear up in eight to 10 days).

The treatment for body lice is a little different and mainly includes improving the personal hygiene of the infected person, per the CDC. Clothing, bedding, and towels used by a person with body lice should also be washed using hot water (at least 130°F) and machine dried using the hot cycle—but that's true for most other types of lice infestations, as well.

Prevent Lice

When it comes to any type of lice, the best prevention is to keep your personal belongings to yourself—and not borrow anyone else's stuff including combs and hairbrushes. There are all kinds of urban legends about people catching lice from airplane headrests or toilet seats, but according to the CDC, the risk of getting infested by a louse that has fallen onto a carpet or furniture is very small. Head lice survive less than one to two days if they fall off a person and cannot feed.

With pubic lice, avoiding sexual contact with an infected person is wise.

And if you or someone in your home has recently had a lice infestation, you don't have to totally redecorate, Dr. Katta said. "After an infection, wash clothing and bedding in hot water and dry it on high heat, if possible," Dr. Katta said. "Look around for stray hairs [and vacuum if needed], but you don't need to go crazy cleaning carpets and furniture."

Other than that, don't stress about lice until you absolutely have to.