[Question #2945] Preventing Pubic Lice

39 months ago
I know that pubic lice is highly contagious, not protected by condoms, and yet oddly is relatively rare here in the U.S. Aside from this, there is very little information online about crabs  so I was hoping the experts here can help she'd a bit more light on this issue. 

I know that shaving doesn’t prevent crabs because they can latch onto even the smallest bits of hair left over from shaving, but what if someone was fully waxed/epilated with 0 stubbles? Is that person immune from catching crabs?

Would shaving down to the stubbles REDUCE the odds of catching crabs?

I have read that many escorts do “bug checks” after each session with a client, in your opinion, is this an effective way of preventing crabs (to check your pubic hair immediately after sex)? Noting the volume of people escorts go through a day, I’m surprised crabs isn’t more prevalent and was curious if this was an effective first line of defense.

Thank you for your time.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
Welcome to the forum and welcome back. Thanks for your question.

To my knowledge, there are no studies on the incidence or risk factors for pubic lice (crabs). Everything we know is on the basis of clinical experience and impressions, and although not to be ignored, this is a poor basis for analysis and understanding. For example, I don't know that the problem is "relatively rare in the US". I'm also not aware of any reliable data that pubic shaving doesn't help preven crabs; if anything, the opposite may be true, that the recent years' trend of increased shaving has significantly reduced the frequency of public lice infestations (https://www.ncbi.nlm.nih.gov/pubmed/24825336, http://www.cc.com/video-clips/cdnpoy/the-daily-show-with-jon-stewart-beasts-of-the-southern-wild). (The second of these links, from Jon Stewart's show, is hilarious, and features a friend and colleague of mine.)

To answer your specific questions:  1) Although the data are weak, it seems likely that pubic shaving reduces the risk of crabs. 2) It's hard for even experienced professionals to idenfity pubic louse infestations. I doubt that "bug checks" by sex workers are very effective in prevention. That said, it may be possible that some escorts are pretty good at it, but there are no data on which to know. (I think you have a mistaken premise in "the volume of people escorts go throug a day". If "escort" means expensive female sex workers by appointment, I doubt this applies to most.)

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

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39 months ago
Thanks for the info doctor. 

Would the complete removal of all of the entire pubic hair follicles (through waxing or epilation so that bot even the shortest tip of hair breaks through the skin) mean that pubic lice will have nothing to grab onto and thus make a person immune to catching it?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
That's the theory, that without sufficienly long hair to grab, the lice cannot establish themselves. "Immune" is too strong: nobody can say that shaving reduces the chance of infestation to zero. But it probably reduces the risk.

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