You may not be aware of a lice infestation. However, common signs and symptoms can include:
- Itching. Itching on the scalp, neck and ears is the most common symptom. This is an allergic reaction to louse saliva. When a person has an infestation for the first time, itching may not occur for two to six weeks after infestation.
- Lice on scalp. Lice may be visible but are difficult to spot because they're small, avoid light and move quickly.
- Lice eggs (nits) on hair shafts. Nits stick to hair shafts. Incubating nits may be difficult to see because they're very tiny and camouflaged to match hair color. They're easiest to spot around the ears and the hairline of the neck. Empty nits may be easier to spot because they're lighter in color and further from the scalp. However, the presence of nits doesn't necessarily indicate an active infestation.
When to see a doctor
See your doctor before you begin treatment if you suspect that you or your child has a head lice infestation. Studies show that many children have been treated for head lice with over-the-counter medications or home remedies when they don't have an active head lice infestation.
Things often mistaken for nits include:
June 18, 2014
- Dead or empty nits from a previous head lice infestation
- Residue from hair products
- Bead of dead hair tissue on a hair shaft (hair cast)
- Scab tissue, dirt or other debris
- Other small insects found in the hair
- American Academy of Pediatrics. Clinical report — Head lice. Pediatrics. 2010;126:392.
- Head lice: Frequently asked questions. Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/lice/head/gen_info/faqs.html. Accessed Jan. 29, 2014.
- Pickering LK, et al., eds. Red Book Online. 29th ed. Elk Grove Village, Ill.: American Academy of Pediatrics; 2012. http://aapredbook.aappublications.org. Accessed Jan. 29, 2014.
- Takano-Lee M, et al. Home remedies to control head lice: Assessment of home remedies to control the human head louse, Pediculus humanus capitis. Journal of Pediatric Nursing. 2004;19:393.
- Di Campli E, et al. Activity of tea tree oil and nerolidol alone or in combination against Pediculus capitis (head lice) and its eggs. Parasitology Research. 2012;111:1985.
- Gunning K, et al. Pediculosis and scabies: Treatment update. American Family Physician. 2012;86:535.
- Pollack RJ, et al. Overdiagnosis and consequent mismanagement of head louse infestations in North America. The Pediatric Infectious Disease Journal. 2000;19:689.
- Goldstein AO, et al. Pediculosis capitis. http://www.uptodate.com/home. Accessed Jan. 29, 2014.
- Head lice: Diagnosis. Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/lice/head/diagnosis.html. Accessed Feb. 3, 2014.
- Anise. Natural Medicine Comprehensive Database. http://www.naturaldatabase.com. Accessed Jan. 29, 2014.
- Ylang ylang oil. Natural Medicine Comprehensive Database. http://www.naturaldatabase.com. Accessed Jan. 29, 2014.
- Mumcuoglu KY, et al. The in vivo pediculicidal efficacy of a natural remedy. The Israel Medical Association Journal. 2002;4:790.
- Hoecker, JL (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 31, 2014.
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