If your scalp starts to itch, or you notice a child scratching their head a lot, you might start to wonder, “Do I have lice?” (Yes, adults can get head lice too!) Sometimes a note comes home from school or you hear from a friend that someone close to your family has lice, and you realize that you don’t really know how to identify head lice.
Don’t worry. It’s not difficult to diagnose or check for head lice once you know what to pay attention to.
The most common, and often the first, sign of head lice is an itchy scalp. Head lice feed on human blood by biting the scalp. Their saliva irritates the skin and causes itching.
Head lice can be seen with the naked eye, but you really need to be looking. In most cases, they pass undetected until there are enough of them biting the scalp to create excessing itchiness. It’s one of the first signs of head lice that most people notice on themselves or on their children.
On the other hand, an itchy scalp could also be dandruff, eczema, or a handful of other skin conditions. It’s important to consider other head lice symptoms and conduct a thorough check of the scalp (see below) before starting any kind of treatment.
An itchy scalp is the most common head lice symptom, but there are others to watch for.
Head lice are very small, but many people report that they can feel the lice moving on their scalps. This is another early sign that confirms people’s suspicions about having head lice—on themselves and on children who complain about the strange sensation.
Note that some children will not think to mention this, so it can be helpful to ask. Sometimes kids are focused on the itching, but when asked about a tickling or crawling feeling, they will confirm that they can feel that too.
In addition to itching, head lice bites are often raised and red. After a day or two of scratching, they may become even more irritated and inflamed—or even infected.
Head lice live on the scalp, but often venture down to the hair line. You may notice a line of raised, red bites behind the ears and along the hairline on the back of the neck.
Lice don’t venture off a host by choice, because they won’t survive more than 48 hours without human blood. They also don’t fly or jump. They can, however, be pulled off a head by a hair brush, hat, or other hair accessory. They can also be accidentally removed by a fingernail, as you run your hands through your or your child’s hair.
Where there is one louse, there are always more.
Similarly, if you find a lice egg, called a nit, anchored to a hair follicle, there are definitely lice. A female louse lives on a human head for about a month and can lay about six eggs per day.
Nits are cemented to hair shafts, so they don’t come off as easily as an adult louse. You won’t remove one by accident, but you may notice very small white bumps on the hair, near the scalp. Similar to finding a live louse, where there is one, there are definitely more.
Head lice are most active in the dark, so the itching and the crawling sensation tend to get more intense at night. This, of course, leads to difficulty sleeping.
If you or a child are being kept up at night by an itchy, crawling scalp, it’s time for a head lice check.
Whether you’re having one head lice symptom or all of them, you will need to roll up your sleeves and investigate.
Get a good lice comb and make sure you have a well lit area to work in. Head lice are visible to the naked eye, but they’re very small. You may also want a magnifying glass or a magnifying mirror if you’re going to try to check yourself.
Part the hair in thin sections to expose as much of the scalp as possible. Lice will scurry away to remain hidden, but you’ll find them eventually if you keep working in small sections. If possible, start behind the ear and along the hairline at the back of the neck.
If you think you might have head lice yourself, it’s usually much easier to get someone else to check for you. You can even make an appointment at a lice clinic or salon.
An adult head louse is about the size and color of a sesame seed. They are white or off-white in color and are standard, wingless insects: with three body parts and six legs.
A nymph is an adolescent louse. They look just like a fully grown louse, but they’re smaller.
Nits are still visible to the naked eye, but even smaller. They are white specks that are glued to the base of a hair follicle, just above the scalp. Nits are often mistaken for dandruff flakes. Where dandruff is easy to brush or blow away, however, nits are very hard to remove.
If you do find lice, don’t worry. Head lice do not carry disease and they infest clean hair as much as dirty hair. They do not live on pets, and they can’t survive off a human scalp for more than two days. You’ll want to start a treatment as soon as possible to relieve the itching and prevent them from spreading to other family members, but there is no need to panic.
There are essentially three options for treating head lice:
Perhaps the most effective, and most convenient, treatment for head lice is an all-natural vapor treatment. This system delivers a proven, chemical-free solution as a vapor that can be applied to dry hair. The treatments are fast and effective.
Our experts field a lot of questions, especially about understanding head lice symptoms and treatments. Here are a few.
You do not need to see a doctor for head lice unless bites are showing signs of infection or the lice have not been eradicated by in-home, OTC lice treatments. If an infection has occurred, your doctor will likely write you a prescription for an antibiotic. If over the counter and natural lice treatments are not effective, your doctor can also write a prescription for stronger lice medication.
If you are having a hard time diagnosing head lice you can also make an appointment to see your doctor for a lice check.
Lice nits hatch after about one week. As nymphs emerge and begin to feed, the itching will probably begin. That means that—at the earliest—you’ve had lice for a week before you start to notice.
In practice, however, most people don’t notice head lice for even longer. It’s not uncommon to be two to six weeks into head lice before you really start to notice. There are a lot of reasons for this, but often include the fact that the bites are small at first and seem random. Head lice is not usually the first thing that people think of.
Head lice will not go away on its own. Females will continue to lay eggs, so every week a new generation of lice will continue to hatch. The longer you wait to confirm that it is head lice and start a treatment, the more insects and nits you will have to deal with.
The most common—and often the first—symptoms of head lice are itchiness, a crawling or tickling feeling on the scalp, and visible bites. If you start to notice these symptoms, or if your child starts to complain about them, get a lice comb and investigate right away.
The next step is to start a treatment as soon as possible, and the easiest way to do that is to decide ahead of time what kind of product or treatment solution you want to use. Once you find lice on yourself or a child, you want to be able to act—not sit down to evaluate treatment options. Evaluate options now, and make sure you’re stocked up on whatever combs, kits, oils, or creams you plan to use.