If you, or someone in your family, starts suffering from an itchy scalp and soon notices small, white specs in the hair, the first question is usually, “Is this dandruff … or lice?!”
White flecks and itching are the first symptoms that most people notice for both conditions, but, of course, dandruff and lice are very different and require different treatments.
It is easy to diagnose, however, once you know what to look for. And don’t worry: neither is very serious and both are easy to treat.
Lice vs. Dandruff: A Quick Overview
Lice are tiny, parasitic insects that feed on human blood. They live primarily on the scalp, but can spread to other facial hair. They do not fly or jump and do not carry disease. Lice infect clean hair as well as dirty hair.
Dandruff is a common condition wherein excess oil builds up on the scalp, causing skin to flake. It is not contagious or dangerous, but can be embarrassing–especially since the flakes are easily shed.
What do lice look like?
Lice nits, or eggs, are very small, white “drops” that are anchored to hair follicles close to the scalp. They can be seen with the naked eye, but most people use a magnifying glass to see them well.
Juvenile and adult lice are small, white or tan insects with six legs. They do not have wings. Full grown lice are about the size of a sesame seed.
What does dandruff look like?
Dandruff flakes are small and white, but may vary slightly in size and shape. Severe cases may cause large flakes or scales. The flakes come away from the scalp easily, so they may be found loosely throughout hair, dusting shoulders, or caught in hats and hair accessories.
Lice and dandruff can look very similar, so how do you know if it’s lice or dandruff? A few simple considerations include:
- Other local cases. Head lice don’t jump or fly, but they are easily spread by head-to-head, or hai- to-hair contact. This means lice tend to spread between children and/or their caretakers. If someone you know has had head lice, there’s a chance your itchy scalp is also lice.
- Sensations on the scalp. Both head lice and dandruff are itchy, but many people with head lice can feel the tickling sensation of lice crawling on their scalps as well.
- Ease of removal. How difficult is it to remove the white specks you can see? Dandruff will come away easily with a fingernail or normal comb. Adult lice will scatter and hide from the light when hair is parted, and nits are very difficult to remove from hair follicles.
Symptoms of Lice vs. Dandruff
If you’re still not sure whether you’re dealing with lice or dandruff, a complete list of symptoms—in addition to the white specks—can help you determine what’s itching your, or your child’s, scalp.
Lice symptoms include:
- Itching and movement on the scalp
- Nits anchored firmly to hair follicles
- Red bumps or sores from lice bites
- Signs of infection, from excessive scratching
- Trouble sleeping, because head lice are more active at night
Dandruff symptoms include:
- Itching on the scalp, especially itching that worsens in cold or dry weather
- Crusting or scaling on scalp
- Flakes may extend to eyebrows and/or fall onto shoulders
- Red, irritated skin (but no bumps)
Treatments for Head Lice vs. Dandruff
While head lice and dandruff feel and look very similar they are, of course, very different, and require different treatments.
Head Lice Treatment
There are three basic categories of head lice treatments:
- Traditional lice shampoos and creams
- Prescription lice treatments
- Natural treatments that don’t use chemicals or pesticides
Choosing the right head lice treatment for you and your family takes a little consideration.
Traditional, over-the-counter lice shampoos are proving less and less effective, as most strains of lice in the U.S. have developed a resistance to the active chemicals in those products. Prescription medications require a doctor’s appointment, but waiting days to see your pediatrician when someone has head lice is just too long.
Some natural treatments for head lice have been scientifically proven to be effective … but many are old wives tales. So while a natural treatment can be your best option, you need to know which ones are actually effective.
For more details on lice treatments, read “How to Get Rid of Head Lice.” →
Dandruff treatments also come in a variety of natural options and medicinal shampoos.
The first step to finding an effective dandruff treatment is to simply wash the hair more thoroughly or more often, or try a different regular shampoo. Many times, shampoo is not strong enough, not applied long enough, or not used often enough, to break through the natural oil barriers of the scalp.
Natural dandruff remedies include treating the scalp with any of the following:
- Tea tree oil
- Coconut oil
- Baking soda
- Apple cider vinegar
- Aloe vera
Dietary considerations can also help treat the underlying causes of dandruff in some cases. You may try increasing your consumption of omega-3s and/or probiotics, for example. Decreasing stress levels can also balance the immune system and reduce symptoms like itching and dryness.
If natural treatments don’t cure the dandruff, there are medicinal shampoos for dandruff as well. The active ingredients vary, but be aware that shampoos containing coal tar or selenium sulfide can discolor light-colored hair and/or skin.
Causes of Lice and Dandruff
A helpful piece of treating and preventing both head lice and dandruff is knowing what causes them to begin with.
Causes of Head Lice
Head lice do not jump or fly and they do not live on animals. Head lice can only be spread by close contact with an infected person. Most commonly, lice spread by head-to-head or hair-to-hair contact—such as children crowding around a book, or teens getting close to friends for a picture, etc.
Lice can also be spread by contact with an infected person’s bedding, hats, or hair accessories, but this is less common. Head lice can only live off a host for 48 hours.
Remember, lice infest clean hair as well as dirty hair, so a case of head lice is not an indication of poor hygiene. While cases are more common in children (because they are in closer proximity more often than most adults), head lice can spread to adults as well.
Causes of Dandruff
The causes of dandruff are more complex. There are several factors and conditions that can cause excessive flaking of the scalp:
- Dry skin — If you have dry skin in general, your scalp may just be one more part of the skin that is suffering.
- Seborrheic dermatitis — The most common cause of dandruff is a skin condition known as seborrheic dermatitis, which affects any part of the skin where oil glands are present. It causes redness and oily skin, which then scales and flakes off.
- Excess yeast — Malassezia is a fungus that lives on everyone’s skin and scalp, but some people’s skin produces too much. The excess yeast causes skin cells to multiply faster than normal. The excess dries and flakes off.
- Allergies — An allergy to a hair-care product can irritate and dry out the scalp. This rough, dry skin then flakes off and appears as dandruff.
Lice and Dandruff Prevention
Once you’ve successfully identified and treated lice or dandruff, you want to make sure it never comes back.
Lice is a parasitic infestation, impartial to cleanliness, ethnicity, or general health.The only way to truly prevent head lice is to avoid the insects entirely, which is difficult, since they are very difficult to see.
If you or someone in your family has head lice, you can take a few steps to prevent others from getting it:
- Isolate the infected individual until treatment is complete.
- Launder or wash any items that have been in contact with the infested hair in the past 48 hours.
- Contact schools and friends who have been with the infested person recently, to advise them to check for head lice.
The only surefire way to prevent head lice is shaving your head. The one thing head lice need is hair.
Some people are, unfortunately, genetically predisposed to developing dandruff. Still, there are measures that anyone can take to prevent (or at least dramatically lessen) the development of dandruff:
- Be sure to wash your hair regularly with a good (normal) shampoo. You may want to try a few options before moving to an anti-dandruff shampoo.
- Use an anti-dandruff or antifungal shampoo, as directed, to keep especially oily skin or other dermatological concerns under control.
- Avoid using chemicals on your hair/scalp that may irritate or dry your skin.
- Use a humidifier at night to avoid dry skin/scalp, especially in the winter or in dryer climates.
Lice vs. Dandruff FAQs
Our experts frequently hear a couple other crossover questions, related to both lice and dandruff.
Can you get lice if you have dandruff?
Yes, you can get lice even while you’re trying to get dandruff under control, but you are not more or less likely to get head lice if you have dandruff. Remember that while lice and dandruff look and feel very similar, lice are parasitic insects that are not partial to clean or dirty hair. They feed on human blood and are not daunted (or attracted) by dry, flaky skin.
Does dandruff shampoo, like Head and Shoulders, kill lice?
Dandruff shampoo is not effective against head lice. The active ingredients in dandruff treatments are designed to moisturize skin, break through excess oils, and combat over-production of yeasts. None of these ingredients has proven effective against killing lice.
The Difference Between Lice and Dandruff
Head lice and dandruff seem very similar in the immediate, but they’re actually quite different. A closer look at a dry, itchy scalp will quickly reveal whether you’re dealing with an infestation of parasites or a build-up of dry skin.
If you can feel crawling in addition to itching, if the white specks are hard to remove, and if friends or classmates have reported cases—you probably have head lice.
But don’t worry. Whether it’s lice or dandruff, neither is very serious, and there are a variety of treatment options available for both. Once you’ve identified the problem, you can start a treatment and find fast relief.