There are several signs and symptoms of a pubic lice infestation, although some people may be asymptomatic. The primary sign is itchiness (pruritus) of the pubic area. Itchiness in other areas of the body with coarse hair (e.g., eyebrows, eyelashes, armpits, legs, facial hair) is less common. Skin in the area may become red, raw and irritated due to scratching.

If the skin is broken due to scratching, secondary infections of the skin (e.g., impetigo) may occur (e.g., if bacteria from the fingernails are introduced to the area).  Tiny pale blue skin lesions (maculae ceruleae) may appear on their inner thighs and/or lower abdomen. Although a distinctive sign of a pubic lice infestation, maculae ceruleae syndrome is not common. It is found most often in people with severe pubic lice infestations.

Another sign of a pubic lice infestation is the presence of white or yellow nits (eggs) clinging to shafts of coarse hair in the pubic region or other areas of the body. Nits are firmly attached to the hair and will not be as easily removed as dandruff or crumbs might be. Pubic lice may be difficult to see because their tan to grayish-white color may blend in with a person’s skin color – although they may be seen with a magnifying glass. Pubic lice also tend to move quickly away from light.  

Sometimes, feces from pubic lice may be seen on underwear or bed linens. These may appear as tiny black specks or flakes that do not move.