How to Check for Lice

Head lice are small wingless parasitic insects that live on the scalp. They can be difficult to spot because they’re only 2 – 3 mm long.[1] Close examination of the scalp and carefully combing the hair are the only ways to check successfully. It is easier to check another person for lice, but you can also check your own head if you have a few mirrors.

Part 1
Part 1 of 4:

Knowing When to Check for Lice

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    Check for itching of the scalp. An itchy scalp is the most common symptom of lice infestation. However, other conditions, including dandruff and scalp eczema, can cause also itchy scalp.[2] Itchy scalps can also be a sign of an allergic reaction to hair care products such as shampoo, too.
    • Some people who have head lice may not experience itching right away. It can take up to six weeks after infestation for the scalp to begin feeling itchy.[3]
    • Some people may also feel a “tickling” sensation on their scalp or head, as though something is moving or crawling.
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    Check for white flakes on the scalp or in hair. White flakes may be caused by dandruff or scalp eczema. They may also be caused by an allergic reaction to shampoos and other hair care products. However, these “flakes” may actually be lice eggs (nits).[4]
    • Dandruff commonly occurs throughout the hair. Lice eggs commonly occur closer to the scalp and are not as widespread as dandruff flakes.
    • If you cannot easily brush or shake the flakes off the hair or scalp, they may be lice eggs.
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    Examine clothes for lice. Lice may find their way into your home on clothes or bedding. They cannot fly, but they can jump great distances.[5]
    • You may see small bugs that look like light-brown sesame seeds on clothing, bedding, skin, or hair.
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Part 2
Part 2 of 4:

Getting Set Up

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    Find a bright light source. Natural light is good if it isn’t filtered through curtains or blinds. Bathroom light is often bright enough. If you need additional light, use a bright flashlight or small desk lamp.
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    Wet the person's hair. This can be done under a faucet or with a spray bottle. Lice can be seen on dry or wet hair, but many people have an easier time spotting lice if the hair is wet.
    • Working with wet hair also makes it easier to carefully part sections, and clip the examined sections out of the way so you can continue to check the remainder of the hair.[6]
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    Recognize adult lice. Adult lice are difficult to see, mainly because they can move quickly and they do not like light. As you separate sections of hair, the adult lice can quickly move back into the hair and into the shadows. Even though an adult louse is tiny, you should be able to see them if you can read the small print of a newspaper.
    • Adult lice are light brown in color, and are about the size of a sesame seed. The adults are often found near the scalp area, in the hair just above and behind the ears, and at the hairline around the base of the neck.[7]
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    Recognize the eggs, also called nits. The eggs are firmly attached, practically cemented, to the hair. Eggs are yellowish-brown, or tan, in color before they hatch, and look like tiny seeds. Freshly laid eggs are shiny, and are often found near the scalp.[8]
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    Identify the hatched nits. Once the eggs, or nits, have hatched, the egg casing remains firmly attached to the hair. The color of the casing is practically clear.[9]
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Part 3
Part 3 of 4:

Examining the Hair for Lice and Nits

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    Start by separating the wet hair into sections. Divide the hair into small sections, and begin by placing the comb near the scalp. Use either a regular fine tooth comb, or a lice comb, and comb through each section of hair, from close to the scalp to the ends. Comb through each section more than once.[10]
    • Lice combs are available at drug stores. They are smaller than a regular comb, but the teeth in the comb are much closer together to more easily search for lice and nits.[11]
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    Continue to comb through the hair in sections. As you finish combing a section of the wet hair, use a clip to separate it from the hair you have not yet examined. Comb through each divided section of hair, examining the comb after each pass through the hair.[12]
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    Examine the area around the ears and the base of the neck closely. These areas are places where adult lice and nits are commonly found.[13]
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    Catch a live louse between your thumb and forefinger. If you see something moving, try to catch it between your thumb and forefinger, then tape it to a piece of white paper so you can examine it more closely. It may be helpful to compare what you have found to documented pictures of lice.
    • Catching a louse with your fingers is not dangerous. By doing this, you can confirm that the person you are examining does have a lice infestation.
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    Don’t confuse dandruff for lice or nits. People of all ages have stuff that gets caught in their hair. Combing through someone’s hair so carefully is likely to reveal dandruff, knotted hair, fabric, and other small things that get lodged in their hair. Nits will not easily comb out since they are cemented to the hair. Use your magnifying glass to examine small things found as you comb through their hair to be sure.
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    Check your own hair for lice. Clearly this is not as easy task, so try to get some help if possible. If you decide to check your own hair by yourself, then follow the same basic steps. Everyone in a household with one infested person should be checked for lice.[14]
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    Wet your hair. Lice and nits can be seen on wet or dry hair, but examining yourself for lice may be easier with your hair wet.[15]
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    Be sure you have enough light. Bathroom lighting is often brighter than the lights in other rooms, plus you will be relying on the bathroom mirrors. If needed, use a small lamp for added light.[16]
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    Use a hand mirror. You will need to closely examine the areas behind and around your ears. Use clips to hold your hair back, and position the hand mirror so you can clearly see the areas you need to examine.[17]
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    Position the mirror to see the back of your neck. Look closely for anything crawling, and for nits or nit casings attached to your hair in this area.[18]
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    Use a fine tooth comb or a lice comb. To best examine your own hair, you will need to separate sections and comb through them several times. Examine the comb thoroughly after each pass through your hair. Continue to use clips the separate the hair you have already examined.[19]
    • Remember to focus on the area around your ears and at the base of your neck. Examining your own hair for lice is difficult, so focusing on the most likely places may help you to determine if you have a lice infestation.[20]
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    Look closely at the comb. You may want to use a magnifying glass to examine the comb each time you pass it through your hair. Identify dandruff, tangled hair, fabric, and other items carefully. Small, seed-like, casings will be firmly attached and will be difficult to remove, likely removing the hair follicle with it as you pass the comb through. This will allow you to closely examine what is pulled out and what remains in the comb, to determine if you have lice or nits in your hair.[21]
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Part 4
Part 4 of 4:

Treating Lice

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    Treat the infested person. You can treat head lice using products available without a prescription. Follow the directions closely, including any measures recommended for safety.[22]
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    Begin by asking the person to put on old clothing. This helps just in case the ingredients contained in the treatment damage the clothing. Also be sure the person has washed their hair, but has not applied conditioner.[23]
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    Follow the product directions. Your doctor or pharmacist can help guide you to best product choices. Once the person has been treated following the directions of the product, examine their hair again in about eight to 12 hours. If you still see lice, but they are moving slowly, then the treatment is still working. Continue with the process of removing as many dead lice and nits as possible by the combing technique.[24]
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    Re-treat if lice are still active. As you examine the hair, notice if the lice are still as active as they were, prior to treatment. If this occurs, follow the package directions to re-treat the person infested.[25]
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    Follow product instructions if re-treatment is needed. Usually, you should re-treat the person’s scalp after one week. Most available products outline how to proceed with a second treatment. Your doctor or pharmacist can help with advice on re-treatment, as well as treating additional family members.[26]
    • Unfortunately, lice have become more resistant to the usual treatments — even some prescription treatments. Your doctor may have to prescribe stronger medications (sometimes to be taken orally) to get rid of the lice.
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    Treat the environment. Wash and dry all bedding, towels, and clothing that the person came in contact going back 2 days prior to treatment. Use hot water, and set the dryer temperature to a high heat setting.[27]
    • Items that cannot be washed can be dry cleaned, or put in a tightly sealed plastic bag for two weeks.[28]
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    Soak combs and brushes. Each time a comb or brush is used to remove lice and nits, soak the items for 5 to 10 minutes in hot water that is at least 130°F.[29]
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    Vacuum the floor and furniture. Head lice only live for about two days once they are not on a person. Nits are not able to hatch if they are removed from the normal temperature of a human body, and die within a week.[30]
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    Wash clothes and soak combs. Make sure you don’t accidentally cause re-infestation. Wash all clothing and bedding in hot water.[31] Store unwashable items in airtight plastic bags for two weeks. Soak combs and other hair accessories, such as bobby pins and clips, in hot water for at least five minutes.
    • Make sure to wash any soft items, such as stuffed animals or pillows, in hot water.
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    Avoid sharing soft items. Lice are often spread to children when they share clothing, hats, scarves, or stuffed animals. Do not allow your child to share these things with others.[32]
    • Do not share soft items between family members until all signs of infestation have disappeared.
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    Continue to closely examine the hair of the infested person. Follow the combing procedure every two to three days, and for two to three weeks, to be sure the person has not been re-infested.[33]
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    Allow your child to return to school. After a successful treatment, your child can return to school the next day. Do not keep your child home from school for several days because of lice infestation.[34]
    • Make sure that your child does not make head-to-head contact with other children at school.
    • Alert your school nurse that you have found lice or nits on your child and that it has been treated. The school may be required to tell other parents that an exposure has taken place so families can be on alert and the nurse can check the possibly exposed students. Do not feel embarrassed as this is extremely common.
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Expert Q&A

  • Question
    I am a boy and I don't know for sure if my head is totally infested by lice, but it itches and I have found two small black-coloured lice so far! What should I do?
    Laura Marusinec, MD
    Laura Marusinec, MD
    Board Certified Pediatrician
    Dr. Marusinec is a board certified Pediatrician at the Children's Hospital of Wisconsin, where she is on the Clinical Practice Council. She received her M.D. from the Medical College of Wisconsin School of Medicine in 1995 and completed her residency at the Medical College of Wisconsin in Pediatrics in 1998. She is a member of the American Medical Writers Association and the Society for Pediatric Urgent Care.
    Laura Marusinec, MD
    Laura Marusinec, MD
    Board Certified Pediatrician
    Expert Answer
    Talk to your parents right away. They should be able to help figure out if you have lice. They can get you a treatment to try. If this doesn't work, or you are still not sure if it is lice, have your doctor check for you.
  • Question
    How can I tell if I have lice?
    Laura Marusinec, MD
    Laura Marusinec, MD
    Board Certified Pediatrician
    Dr. Marusinec is a board certified Pediatrician at the Children's Hospital of Wisconsin, where she is on the Clinical Practice Council. She received her M.D. from the Medical College of Wisconsin School of Medicine in 1995 and completed her residency at the Medical College of Wisconsin in Pediatrics in 1998. She is a member of the American Medical Writers Association and the Society for Pediatric Urgent Care.
    Laura Marusinec, MD
    Laura Marusinec, MD
    Board Certified Pediatrician
    Expert Answer
    Follow the instructions in the article to tell if you may have lice. Notice for itching and look for white flakes, or brown or black small bugs. If you are not sure, have another person help you look, or see your doctor.
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Things You”ll Need

  • Fine tooth comb, or lice comb
  • Good lighting
  • Magnifying glass
  • Spray bottle with water
  • Tape
  • White paper
  • Hand mirror

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References

  1. ↑ http://www.cdc.gov/parasites/lice/head/
  2. ↑ https://www.aad.org/public/diseases/a-z/head-lice-symptoms
  3. ↑ https://www.mayoclinic.org/diseases-conditions/head-lice/symptoms-causes/syc-20356180
  4. ↑ http://kidshealth.org/parent/infections/common/head_lice.html
  5. ↑ https://www.aad.org/public/diseases/a-z/head-lice-symptoms
  6. ↑ https://www.aad.org/public/diseases/a-z/head-lice-treatment
  7. ↑ https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/e---h/head-lice/diagnosis-treatment
  8. ↑ https://kidshealth.org/en/parents/head-lice.html
  9. ↑ https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/e---h/head-lice/diagnosis-treatment
  1. ↑ https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/e---h/head-lice/diagnosis-treatment
  2. ↑ https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/e---h/head-lice/diagnosis-treatment
  3. ↑ https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/e---h/head-lice/diagnosis-treatment
  4. ↑ https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/e---h/head-lice/diagnosis-treatment
  5. ↑ http://headlicecenter.com/how-to-check-for-lice/
  6. ↑ http://headlicecenter.com/how-to-check-for-lice/
  7. ↑ http://headlicecenter.com/how-to-check-for-lice/
  8. ↑ http://headlicecenter.com/how-to-check-for-lice/
  9. ↑ http://headlicecenter.com/how-to-check-for-lice/
  10. ↑ https://www.nhs.uk/conditions/head-lice-and-nits/
  11. ↑ http://headlicecenter.com/how-to-check-for-lice/
  12. ↑ http://headlicecenter.com/how-to-check-for-lice/
  13. ↑ http://www.cdc.gov/parasites/lice/head/treatment.html
  14. ↑ http://www.cdc.gov/parasites/lice/head/treatment.html
  15. ↑ http://www.cdc.gov/parasites/lice/head/treatment.html
  16. ↑ http://www.cdc.gov/parasites/lice/head/treatment.html
  17. ↑ http://www.cdc.gov/parasites/lice/head/treatment.html
  18. ↑ http://www.cdc.gov/parasites/lice/head/treatment.html
  19. ↑ http://www.cdc.gov/parasites/lice/head/treatment.html
  20. ↑ http://www.cdc.gov/parasites/lice/head/treatment.html
  21. ↑ http://www.cdc.gov/parasites/lice/head/treatment.html
  22. ↑ http://www.cdc.gov/parasites/lice/head/treatment.html
  23. ↑ http://kidshealth.org/parent/infections/common/head_lice.html#
  24. ↑ http://www.cdc.gov/parasites/lice/head/treatment.html
  25. ↑ http://kidshealth.org/parent/infections/common/head_lice.html#

About This Article

Laura Marusinec, MD
Co-authored by:
Laura Marusinec, MD
Board Certified Pediatrician
This article was co-authored by Laura Marusinec, MD. Dr. Marusinec is a board certified Pediatrician at the Children's Hospital of Wisconsin, where she is on the Clinical Practice Council. She received her M.D. from the Medical College of Wisconsin School of Medicine in 1995 and completed her residency at the Medical College of Wisconsin in Pediatrics in 1998. She is a member of the American Medical Writers Association and the Society for Pediatric Urgent Care. This article has been viewed 350,539 times.
15 votes - 92%
Co-authors: 23
Updated: February 22, 2022
Views: 350,539
Categories: Featured Articles | Animal to Human Infections (Zoonoses)
Article SummaryX

To check for lice, start by wetting the person's hair and separating it into sections. Then, use a fine-tooth comb or a lice comb to brush through each section of hair, starting at the scalp and working your way to the ends. After you comb through each section, check the comb for lice or eggs. You should also examine the hair around the person's ears and neckline since that's where adult lice are commonly found. To learn how to get rid of head lice, scroll down!

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