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Head Lice: Symptoms, Causes & Diagnosis

Head Lice: Symptoms, Causes & Diagnosis
Created on 
April 15, 2017
Updated on 
May 5, 2023

When parents see their school-aged children scratching, they may wonder if this is one of the early symptoms of head lice. This is not always the case, especially since, in some people, itching is not even a symptom of an active case of head lice until it becomes severe or very severe. No one with hair is immune to lice…not even adults. The fact is, anyone can get head lice if they have even a 1/4 inch of hair. All it takes is direct head-to-head contact with another person who has lice. There are other tell-tale symptoms of head lice you should watch for as not everyone experiences itching.

The lice treatment process with LiceDoctors is fast and straightforward. You will not only save time and money but also get a guarantee that your service will be effective.

7 Common Signs and Symptoms of Head Lice

You won't find active lice bugs crawling on your child's hair until the infection gets more advanced. By the time the kids have very bad itching, they've already had head lice for weeks. Since you may not spot bugs early on, look for other signs and symptoms.

What are the symptoms of lice?

1. Itching

head lice symptoms

The primary indication of head lice is an itchy scalp. This common symptom tends to be centered around the nape of the neck, behind the ears, and in other dark and warm locations where the bugs can hide. In severe cases, the whole head may itch, including the scalp neck, and shoulders.

This is one of the most common symptoms most people look out for. The itch associated with head lice can be caused by two factors. Head lice bite causes itching from the saliva from the louse when it bites the scalp. The other cause is the movement of live bugs on the scalp. Some people may be super sensitive and start itching early in the infestation, while others never have itching. So this is not a 100% reliable way to judge if a person has head lice.

2. Irritability

Another of the many symptoms of head lice is irritability. This may come as a surprise to some, but it is a common symptom, especially for those who are particularly sensitive to the sensation of bugs crawling around on their head or to the lice bites.

Increased discomfort and hypersensitivity to what is going on in the person’s head can cause them to not focus and complete tasks. Imagine trying to focus on an important task but being unable to do so because there is a constant, unknown sensation in your head. This leads us to another of the many symptoms of lice in hair.

3. Sleep Problems

prevent head lice

Itchiness from head lice at night and living in an agitated state can cause difficulty sleeping, which results in a person being more cranky than they may normally be. Lack of sleep makes it more difficult to focus and over time can have a major impact on a person’s mood.

If you notice you or a family member has had difficulty getting sufficient restful sleep, has been crankier than usual, and is scratching, these are sure head lice infestation symptoms that should not be ignored.

4. Red Bumps on Your Head and Neck

While lice signs and symptoms on the head are common and expected, another place to keep an eye out for bumps is on the neck. In the case of head lice, a person can develop red bumps on their head and neck. These can become inflamed and cause considerable discomfort.

This is often present in severe cases of head lice but can also be visible in persons who are particularly sensitive to cases of lice, specifically their bites, which cause the person to scratch a lot. While red bumps on your head and neck can be symptomatic of other types of skin irritations, it is a symptom that should prompt thorough head lice to check.

5. Sores on Your Head

symptoms of head lice

Some of our clients ask if can lice cause sores on the scalp. If you’re dealing with sores on the head, this could be another indication that you may be dealing with head lice.

These lice sores are often the cause of head lice bites. Head lice sores result from scratching an itchy louse bite. The more severe the itch, the more intense the scratching, and the likelihood of sores increase.

Keep in mind that some people do not react to these bites. So if you have other symptoms of head lice but no sores, this does not mean you do not have lice.

6. Little White Balls on Your Head

It’s not uncommon for us to hear from a client inquiring what the symptoms of lice to disclose that they have little white balls in their hair. This could be one of the symptoms of head lice: nits.

Nits are tiny eggs glued to the strands of hair but are not truly white. They tend to blend in with the hair color and, when placed against a white background, appear brownish.

If you have found something whitish in your hair, and it moves easily off the hair, it’s not a nit. Nits are firmly glued, not easily removed, and do not appear white in the hair. DEC plugs, however, do appear white in the hair and are sticky-like nits. These are tiny globs of oil secretions from clogged glands on the head. When placed against a white background, they remain white.

7. Crawling Sensation

In advanced lice, many crawling insects may produce a creepy, tickling sensation. Some people never feel moving lice, so don't go by this alone.

Other scalp conditions can also cause a phantom crawling sensation and inconveniently tend to be correlated with white things in the hair. If the white specks and crawling sensation come and go with hair washing, rule out skin conditions.

Also, it's common to experience psychosomatic itch or crawling insects sensation when you think about lice. If you're wondering, "Do I have lice or am I paranoid?" the sensation can amplify until you get checked for peace of mind.

What Are the Complications of Head Lice?

The good news is, head lice infect only human head hair. Unlike body lice, head lice infect hair attached to a human scalp; there's no risk that head lice will spread to other human body parts, inanimate objects, or environments.

More good news: head lice don't spread diseases. All known contagious diseases caused by lice infestation are attributed to other species of lice.

The bad news is, untreated head lice may lead to other medical issues. Advanced lice may cause intense itching, and frequent scratching can lead to a skin infection. Rarely, if a child has head lice for a long time, anemia may develop, since head lice feed on human blood.

Causes and Risk Factors of Head Lice

lice symptoms

While any human with head hair can get head lice, certain groups may be more or less at-risk:

  • Age: most cases of head lice are spread among children aged 3-11. At this age, your child has the most close contact with other people, through play, snuggling, or co-sleeping. Your school-aged child is also potentially exposed during close contact in crowded hallways between classes;
  • Sex: girls catch lice more often than boys because their longer (on average) hair touches others more frequently. Girls are often socialized to hug or play with each other's hair more than boys. Adult and young adult males catch lice less often than females and children, which might be because testosterone slightly repels head lice;
  • Hair texture: the curlier and coarser your hair, the less likely you are to catch lice. Lice move through the hair like monkey bars, using their claws. American lice may be more likely to have claws that can grab round straight hair shafts easier than flat curly hair shafts. A child with coarse, dry hair may also shampoo less often, leaving natural oils and products which make it harder for the head louse to glue its eggs to the hair shaft;
  • Family members with lice: Lice may spread more quickly among related people since lice seem to prefer people with the same blood type they were raised on.

But still, if there is an outbreak in your household, check everyone, regardless of signs and symptoms.

How to Diagnose Lice?

Head lice are tiny insects about the size and color of a sesame seed, with six legs and long abdomens. You'll see a dark spot in the translucent abdomen when the head lice drink human blood from their human host. But before you see adult lice, you'll spot lice eggs (nits) and nymphs (smaller baby lice earlier in the life cycle). Even empty nits stick to the hair shaft until picked out.

But don't wait for the common symptom of an itchy scalp; you can diagnose an infection before it's visible:

  • Rub olive oil into your child's hair (As a bonus, this often helps quell an itchy scalp);
  • Use a nit comb to comb each section of hair from the scalp to the ends of the hair shaft in bright light;
  • A metal comb with very fine teeth like the Terminator nit comb is best;
  • Plastic nit combs or a fine-toothed comb for styling aren't effective;
  • If you find even one head louse or nit, assume the child has lice even if other signs and symptoms are absent.

This is the method your LiceDoctors technician will use to check for lice and their eggs before symptoms of hair lice develop.

When Is It Better to See a Doctor?

lice symptoms

When over-the-counter treatments don't work, parents tend to assume they need prescription head lice medicines to treat lice. But even when you see a doctor, it is usually not enough to treat head lice, since no matter the topical treatment, you'll still need to remove the lice eggs with a fine tooth comb. Regular doctors won't remove lice eggs, but LiceDoctors will!

If head lice or products used for treating lice cause pain, fever, open sores, swelling, or severe allergic reactions on the skin, clinical dermatology may be necessary for the proper treatment of the tender skin.

How to Prevent Head Lice?

If you’ve been fortunate enough to dodge head lice, it would be prudent to prevent ever having to. There are a few practical preventive strategies that we recommend, each of which helps prevent head lice:

  • Avoid close contact with a person with head lice. 95% of the time, head lice spread via head-to-head contact;
  • Don't share hair brushes among children or family members in the household;
  • If you share bedding among children, wash it in hot water in between;
  • Keep the hair tied in a bun or braid;
  • Keep the hair artificially dirty - we recommend our LiceDoctors Head Lice Peppermint Repellent Spray;
  • Educate your family on how head lice is transmitted and avoid high-risk situations;
  • Teach kids not to share personal belongings that come in direct contact with human hair.

Contact LiceDoctors if You Experience Head Lice Symptoms

Diagnosing your case of head lice can prove difficult. This is not an all-inclusive list of symptoms of head lice. Also, each common symptom on its own can be indicative of another skin condition.

If you have symptoms of head lice, call LiceDoctors at 800-224-2537 to book an appointment. Our professional head lice technician will thoroughly check the whole family, let you know who has lice, and eradicate the head lice problem if there is one.


How long can you have lice before noticing?

You won't notice head lice immediately after infestation. It is rare to detect an adult louse early on. Often, there are no obvious signs of lice until the infestation reaches moderate to severe levels. By the time symptoms are obvious, like visible adult lice and several lice eggs with intense itching, the case of head lice has likely been present for a month or more.

How long after exposure do symptoms of head lice appear?

How long after exposure to head lice will symptoms appear? This will vary from person to person. If a person is very sensitive to movement on the scalp and is more sensitive to the effects of the lice bites, he or she may feel symptoms after a week or less. Others may not notice an infestation for one or more months. So there is no clear answer to how long after exposure to lice symptoms reappear.

Do kids with lice symptoms need to stay home?

Some schools have “no-nit” policies, meaning the child may not go to school until all nits are removed from the hair shafts. The American Academy of Pediatrics recommends against this now, since nits aren’t contagious and can't spread disease, and missing school may cause more harm. However, families should take precautions not to spread lice at school. Most symptoms indicate the presence of contagious live lice, so children with symptoms should follow the prevention advice above.

What is commonly mistaken for lice?

Other things that may be mistaken for lice include both skin conditions and other insects. Dandruff, debris, or product residue is easily removed from your child's scalp or her hair by brushing or washing. Hair casts are white cylindrical structures surrounding hair strands that slide off hair shafts and squish. DEC plugs are a white oily or sticky substance secreted by hair follicles that are NOT firmly attached to hair shafts. Fleas are darker and harder, and they jump and bite other body parts and other animals. Ticks have eight legs and affect other body parts and other animals. Carpet bugs bite other body parts and you'll rarely find them crawling on the human body. Bed bugs are larger, about the size, shape, and color of an apple seed, and cause blood stains on bed linens. They live in furniture, so you rarely find them in a child's hair. Body lice look very similar, but lay their eggs on clothing, not on a child's hair. Body lice may cause an itchy scalp but also bite other body parts.

Is head lice the result of poor hygiene?

Keeping a clean house cannot prevent the spread of head lice (although it can prevent body lice). Since head lice can't live long off a human host, house cleaning is not effective disease control for head lice. The hot water of a shower can't kill lice or get rid of head lice eggs (nits). Head lice spread easily in clean hair more so than in dirty hair.



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