7 Clear Signs Your Child Has Head Lice

While they might give you the creepy crawlies, head lice shouldn't be cause for panic. Still, you'll want to spot them early. Here's how.

Little kid in a classroom with their hands covering their face.
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You got a warning letter from their school

Head lice affect about six to 12 million children aged three to 12 each year in the United States, according to the American Academy of Dermatology. Most schools and childcare centers will send a note home to parents as soon as a fellow student has been discovered with head lice. “Usually this letter just says that lice has been found within the school or classroom,” says Angela J. Lamb, MD, the director of the Westside Mount Sinai Dermatology Faculty Practice and chief technology officer of the dermatology department at Mount Sinai in New York. This may mean checking your child for lice if the school hasn’t already done so. Don’t panic: Lice don’t carry disease or indicate poor housekeeping; they’re simply a parasite transmitted via head-to-head contact. Lice can’t jump, hop, or fly (though they can become projectiles through static electricity), and altering your child’s routine to avoid them is unnecessary. Instead, discourage your kid from sharing hair supplies and hats, and from touching heads with others. Try these 10 home remedies that can get rid of head lice.

Little girl with pigtails itching her scalp.
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They’re constantly scratching

One of the most obvious head lice symptoms is an itchy scalp, Dr. Lamb says. “This is one of the first signs.” The tickling sensation is the result of an allergic reaction to louse saliva, and is most common around the top of the head, neck, and ears. Children might also report feeling a moving sensation, which occurs as a result of the tiny insects crawling through their hair, she says. “If you are concerned, check your child’s head or make an appointment to see your pediatrician or dermatologist to find out what is going on.” Check out these 14 tips that professional “lice ladies” wish you knew.

Little girl lying in white bed trying to sleep.
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They’ve had trouble sleeping

This head lice symptom goes hand-in-hand with itchiness: Because lice are most active at night, children might experience more itchiness in the evening and have trouble falling asleep, Dr. Lamb says. “You may also see scrapes or open sores on their necks.” If you notice your child twisting and turning at night, or acting irritable from a lack of sleep, you might want to check his or her scalp. If the signs are true, check out this remedy for lice that includes just one essential oil.

Boy's hair with dandruff.
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They’ve got dandruff that just won’t let up

Lice eggs (or nits) can often take on the appearance of dandruff (and vice versa, so make sure you’ve diagnosed your child correctly by taking them to a professional before starting treatment). “A lot of things can look a lot like lice that aren’t,” Dr. Lamb says. Nits are oval in shape and about the size of a knot in thread; they’re usually yellow or white in color and latch onto hair shafts about a quarter-inch from the scalp. So how can you tell them apart from dandruff, hair-product residue, dirt, and other harmless lookalikes? They won’t budge. If that itchy scalp is actually due to dandruff, consider these 11 dandruff home remedies to clear things up fast.

Parent checking a little boy's hair and throat.
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You see small red bumps on their neckline

Another one of the many head lice symptoms are any signs of irritation on the base of your scalp and neck. Red bumps in these areas can hint at intense scratching, which can occasionally lead to infection, Dr. Lamb says. This map shows where head lice has become resistant to standard treatments.

Little girl in the doctor's office with swollen lymph nodes.
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They’ve got swollen lymph nodes

If broken skin from frequent scratching results in infection, you might notice the lymph nodes behind your child’s ears and on his or her neck become tender and swollen. Consult your doctor on this one. Your child might need a round of antibiotics. “This would be a really bad lice infestation and is not so common,” Dr. Lamb cautions. Here are 12 ways you can get lice.

Person combing through a child's hair with a nit comb.
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You see physical evidence

Because lice are tiny (about the size of a sesame seed) and their eggs even tinier, physical evidence can be hard to spot. Pick up a lice comb (or a very fine-toothed comb) and wet your child’s hair. Slide the comb from scalp to end, checking its teeth after each swipe. A magnifying glass might be necessary, Dr. Lamb says. If you do find lice, don’t panic. Once you notice that your child has head lice symptoms, contact your doctor, who will give you prescription medication and treatment instructions. These are 21 reasons that your scalp itches besides lice.

Sources
  • Angela J. Lamb MD, director or Westside Mount Sinai Dermatology Faculty Practice and chief technology officer in the dermatology department at Mount Sinai, New York, NY.
  • American Academy of Dermatology: "Itchy Scalp? How to Find Head Lice Early."
 
Medically reviewed by Jessica Wu, MD, on October 27, 2019