Lice are tiny parasitic insects that feed on blood and live in hair. But what are the symptoms to look out for to catch and treat lice quickly?

Head lice can infest the hair, eyelashes, and eyebrows, while pubic lice infest the pubic hair.

The idea of bugs crawling in your hair or your child’s hair can be unnerving and upsetting. Contrary to folk wisdom, lice aren’t the result of poor hygiene, and they don’t carry diseases.

However, they can cause a lot of discomfort and spread easily to other children. Catching lice early and treating them appropriately helps ensure they do not spread. This article gives an overview of the symptoms so people can answer the question: is it lice?

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Lice are about the size of a small seed and feed on human blood from the scalp.

The head louse, Pediculus humanus capitis, is a tiny insect that feeds on human blood and lives on the scalp and in the hair.

Lice are tiny, measuring only about 2-3 millimeters, about the size of a small seed. Adults are oval-shaped and grayish-brown with no wings. From a distance, they look like little more than tiny specks. That might be why it is so easy to miss a lice infestation.

Adult lice live about 30 days, and quickly die if they fall off the head. They are prolific breeders, with females laying about six eggs per day.

Eggs are sometimes called nits and tend to be located at the root of the hair, right next to the scalp. They are tiny and look white or clear in colour.

Eggs hatch into nymphs, smaller versions of adult lice, which mature into adults about 2 weeks later.

Seeing either lice or eggs indicates a head lice infestation since eggs inevitably hatch into adults. The only way to get rid of head lice is to kill both the living insects and the eggs they lay.

Many people with head lice have no symptoms at all. It’s impossible to diagnose head lice based on symptoms alone since the only symptom that matters is the presence of lice.

However, experiencing the following symptoms suggests it is time to check the scalp:

  • frequent unexplained itching of the head or scalp
  • redness or inflammation on the scalp or near the hairline
  • tiny red bumps or sores from scratching the scalp
  • difficulty sleeping or concentrating due to head itching

Dandruff, some scalp infections, and dry skin can cause symptoms similar to head lice. Because dandruff causes flaking, the flakes may be mistaken for lice nits.

Checking for lice

A diligent search for lice with a magnifying glass and good light can help discern the difference between lice and other symptoms.

People should look for bugs moving on the scalp, or for eggs attached to the hair shaft, an inch or so from the scalp.

It may be easier to see lice and their eggs when the hair is wet. So, if lice are not visible under a light, try washing the hair and then looking again.

If no lice are visible, but the scalp is itchy, people should consult a doctor. The doctor may be more adept at detecting lice and can rule out other potential causes of symptoms.

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Children are more prone to lice because they come into close contact with other children through playing, hugging, and sharing hats and scarves.

Lice can only be spread by direct contact with someone who has them. They do not spontaneously appear, and they have nothing to do with hygiene.

Lice cannot hop or fly, which means the contact has to be close. Because young children spend so much time in close quarters with other children – and are often eager to share – they tend to get lice more than adults. Parents of young children are also vulnerable.

Lice can spread through:

  • hugging or nuzzling someone
  • sleeping next to someone, with their head or hair in direct contact
  • sharing brushes or combs, especially immediately after someone with lice uses them
  • sharing hats or scarves, especially if they are passed back and forth quickly since lice die quickly when not on a human head
  • sharing towels

Lice treatment is usually pretty straightforward. An over-the-counter shampoo can kill the lice and their eggs. People should always follow the instructions on the packaging.

Using shampoo

In most cases, the shampoo will need to stay on the scalp a day or two to work, so the hair should not be washed immediately after treatment. Most shampoos require a second treatment 7-9 days after the initial application.

People should carefully read the instructions to ensure they can understand and follow them.

Checking the scalp

After waiting a day or two, people should check the scalp. If many lice are still present and active, they might be resistant to treatment.

People should follow the package instructions for a second treatment, or contact a doctor to get a recommendation for a second treatment.

Combing the hair

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It is important to remove all of the eggs to prevent further outbreaks.

In most cases, lice treatments require a thorough combing of the hair to remove eggs.

Even if successful in killing all the adult lice, it is crucial to remove all the eggs, as they will hatch into nymphs that become adults.

Removing eggs may need to be a daily undertaking for several days following treatment.

Being careful with sensitive scalps

In people with allergies, a history of scalp infections, or an injured scalp, it may not be safe to use over-the-counter lice treatments. Talk to a physician before trying a lice shampoo.

Treating challenging infestations

In some people, getting rid of lice proves more challenging, which may be due to:

  • the extent of the infestation
  • re-infestation thanks to a school or workplace with a lice problem
  • lice that are resistant to lice shampoo

When this happens, a more aggressive approach may be necessary, including:

  • frequent washing with a lice shampoo
  • removal of nits
  • consultation with a doctor

Some businesses also specialize in lice removal.

Note that regular shampoo, water, folk remedies, and medications, such as antibiotics will not kill lice.

Though anti-itch treatments might offer temporary relief from the itching lice cause, they won’t address the underlying lice infestation.

Parents often struggle to get young children to practice even basic hygiene, such as washing hands. So asking them to minimize the risk of spreading lice is a daunting undertaking.

Some strategies that help to reduce the risk include:

  • not sharing headgear, brushes, or combs, or washing these items before donating or sharing
  • ensuring each family member has a personal pillow or pillowcase
  • cleaning or disposing of items that a person with lice has used
  • urging children to respect the personal space of their friends by not rubbing heads or sleeping in close quarters
  • keeping children with lice home until the infestation has been cleared

Families in which one member has lice are vulnerable to further infestation. People should check all family members for symptoms of lice, and treat as needed.

Some other strategies to prevent lice from spreading among family members include:

  • replacing all combs and brushes
  • washing all clothes, hats, and scarves before wearing them again
  • replacing pillows and pillowcases used by the person with lice