Elk lice photo and description

What Do Lice Look Like?

What are lice?

It’s the call from the school nurse that no parent likes to hear: “Your child has head lice.” It is estimated that 6 to 12 million children under the age of 11 become infested with head lice every year. Though head lice are not exclusively a childhood ailment, the majority of people affected by head lice are young.

The head louse, scientific term Pediculus humanus capitis, is a parasite that feeds on human blood. Learning what head lice look like and how to detect them can help control an infestation before it spreads through the entire household.

Three forms of lice

Three forms of head lice exist: nits, nymphs, and mature adults. Nits are lice eggs that attach to the hair shaft and usually hatch within a week. The microscopic eggs are easy to mistake for dandruff or residue from hair styling products.

Once the eggs hatch, lice are known as nymphs, an immature form of the parasite that is grayish tan in color. After nine to 12 days the nymphs mature into adults, the average size of which is roughly 2–3 millimeters, or about the size of a sesame seed.

Where do head lice live?

Head lice feed on blood and therefore stay close to the scalp where there is an abundant supply of food. After the nits hatch, they move from the hair shafts to your scalp to find sustenance.

You’ll find nymph and adult lice most commonly on the scalp around the back of your neck and ears. They might also live in your eyebrows or on your eyelashes. When fed, head lice can live for up to a month, but they will die within a day or two if they are not able to feed on blood.

Creepy crawlers

Head lice are insects, but they can’t fly. Instead, they crawl around in your hair and on your scalp to get nourishment. Lice are spread through close personal contact. The parasites crawl onto your clothing, hairbrushes, hats, towels, and any other personal belongings.

If a friend or family member shares your comb or scarf, the head lice can crawl onto the new host and lay eggs, spreading the infestation. Female head lice can lay several eggs each day. Household pets and other animals do not spread head lice to humans.

Detecting head lice: Symptoms

Some people experience the uncomfortable symptoms of head lice before noticing them in the hair, while others are asymptomatic. Head lice bite you in order to feed off your blood. The parasites’ saliva is irritating to many people, causing itching of the scalp. You might develop sores or red, raised bumps on your scalp from scratching your head without realizing why you are itchy at first.

Other symptoms that alert you to a case of head lice include a ticklish feeling on your head, especially at night. The head louse is a nocturnal creature and is more active in the dark than during the light of day.

Detecting head lice: Visual inspection

A visual inspection of your hair and scalp is usually effective in detecting head lice, though the creatures are so small that they can be difficult to spot with the naked eye.

Parting your hair in small sections and literally going through each section with a fine-tooth comb is a painstaking but necessary step to find and remove head lice. A bright light and a magnifying glass are useful tools to aid in the detection and diagnostic process.

Head lice are treated through manual removal with a comb as well as special shampoos containing chemicals that kill lice. Even if just one nit or adult louse is found, treatment is advised to reduce the threat of a full infestation.


Childhood Skin Problems

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Head lice are usually found in hair, most often on the back of the neck and behind the ears. Head lice are common in preschool and elementary school-age children. Adults can get them too, especially adults who live with school-aged children.

The most common treatment is an over-the-counter or prescription cream, lotion, or shampoo. You apply it to the skin or scalp to kill the lice and eggs. In some cases, you may need treatment a second time to make sure that all the eggs are dead. Some medicines don’t kill the eggs. Be sure to follow all instructions exactly. In some areas, lice may be resistant to certain medications. Speak to your doctor about which medicine may be best to treat the lice.

Some people have an allergic reaction to lice bites that causes itching for 7 to 10 days after the lice and eggs have been killed. Steroid creams or calamine lotion can relieve the itching. If you have severe itching, antihistamine pills may help. But don’t give antihistamines to your child unless you’ve checked with the doctor first. Read more about the symptoms, treatments, and prevention of head lice.

Image: © 2007 Interactive Medical Media LLC. All rights reserved.

Text: “Lice – Topic Overview”, WebMD Medical Reference from Healthwise


Elk Grove Lice Problems Have Parents Itching For School Policy Change

ELK GROVE (CBS13) — Parents in Elk Grove are frustrated after battling head lice for months.

Now they’re calling on the district to step in and change school policy on when to send a child home if they’re infected.

“If that were to change, that would prevent all of this infestation that’s going on,” said Jenn Moore, a mother of three who had a tough time battling lice in her household.

Last week, Elk Grove mom Traci Feaster started a petition on change.org to change the Elk Grove Unified School District’s policy on lice. Back in July 2015, it changed from a “no-nit” policy to a “no live lice” policy. Before, if students had lice eggs, known as nits, they had to stay home. Now, only live lice keep a child out of school. In short, children with lice eggs but no live bugs don’t have to stay home.

“It just felt like tiny little bugs again like just crawling through my hair,” said Moore’s 9-year-old daughter Loie Moore.

In November, the 4th grader came home from school with a head full of lice eggs. Her 8-year-old sister Meelah had them too along with live lice bugs.

“She found it in her hair so then they called me up and I’m like ‘what the?’ I didn’t even know,” Loie said.

Her mother took the family to Lice Clinic of America for treatment where they found out that Jenn had eggs in her hair too!

“I wanted to tell everybody,” Moore said. “I was like ‘check your kids. They don’t send home notices anymore. Both my kids have it!’”

Feaster hopes EGUSD will revert back to the previous policy before the 2015 change. But EGUSD spokesperson Xanthi Pinkerton said in a statement the old policy “caused an increase in absenteeism.” Furthermore, “…new protocol notes that head lice do not transmit disease to humans.” The statement goes on to say “District officials have acknowledged the parent’s petition and will be meeting with school nurses to discuss the current ‘no-live lice’ protocol.”

“I’m just glad it’s gone,” Loie said.

While the family is lice-free now, Moore told CBS13 going back to a “no-nit” policy means a safer school for all students and their parents.

Right now, if a student is sent home because of lice, the absence is not excused. EGUSD told CBS13 it plans to review that policy during the meeting with school nurses.

when my kids were small had the same problem I have two girls with lots of beautiful hair and took hrs and a lot of money to get rid of them .I got so frustrated begin looking for some thing to protect them from getting it .I found that if you use tea tree oil shampoo and conditioner as a regular shampoo and when they go to school put few drops of tea tree oil in there hair and always keep in tight pony tail they never got them again hope this helps someone


Head Lice Picture Gallery

Head Lice Infestation in a Girl with Long Hair

A young girl with a head lice infestation. Although it is hard to see it, there was a large, live louse in the shot a second before the picture was taken, which just goes to show how hard it can be to find lice sometimes, especially in girls with long hair.

Adult Head Louse

This is a magnified picture of an adult head louse. In reality, mature head lice are about the size of a sesame seed.

Note the characteristic six legs of this crawling insect. If you magnified this louse even further, you might be able to see the small claws on the end of their legs that lice use to grasp hair.

Adult Head Louse

The female head louse is a little ‘fatter’ than a male, which is a little skinnier.

Head Louse Close-Up Picture

Although this head louse is magnified, you can use the nearby strand of hair for comparison to understand how big head lice really are. This can help you to identify head lice on your child’s hair during a lice infestation.

Head Lice Pictures

This unmagnified picture of a head louse shows what to expect when you search your child’s head for live lice.

Instead of worrying when you think your child has head lice, you should first confirm that your child has head lice. Reviewing head lice pictures like this one can help you understand what you are looking for, including live lice and nits (lice eggs) in your child’s hair.

Looking for Head Lice: Do you See Them?

Can you spot the head louse on this girl’s head in this picture of a young child with a head lice infestation?

A Picture of a Live Louse on a Child’s Head

This picture is of a live head louse on a girl’s head, with a red circle around the louse to make identification in this head lice picture easy.

Pictures of Nits

Nits are the eggs of lice. Nits are small, oval shaped and usually a yellowish-white color and are firmly attached to the side of hair shafts.

Simply having nits does not necessarily mean that your child has live lice, though, since some nits may be empty egg casings and some may have dead, non-infective lice embryos inside.

Nits that are close to your child’s scalp are the ones that are most likely to be infective and are the ones that are thought to hatch into live lice, a process that takes seven to 12 days. Continuing to get new nits, even after you have removed nits from your child’s hair, is also likely a sign that your child has live lice on her hair and needs a lice treatment.

A live louse will typically lay up to 10 eggs a day, so if your child only has a few nits, then she likely doesn’t have an active lice infestation.

The American Academy of Pediatrics is against no-nit policies that exclude children from school because they have lice. In fact, the AAP now states that ‘No healthy child should be excluded from or allowed to miss school time because of head lice.’ This is likely a big surprise to all of the parents who have had their kids sent home from school because of head lice.

To add to the confusion about head lice, some people only use the term nits to refer to empty egg casings and lice eggs when talking about viable lice eggs. Others use the term nits to refer to both viable lice eggs and empty egg casings.

More Pictures of Nits

This is an out of focus picture of a nit, or head lice egg, with a caption and red circle around the nit to make identification easy. Did you find the nit on your own?

Lice Life Cycle Picture

Having a hard time figuring out what you are looking for when you think your kids have lice? This picture of the three stages of the head lice life cycle can help.

This picture shows the three stages of the head lice life cycle, including the head lice egg or nit, nymph, and adult louse, as compared to the size of a penny for scale.

Louse Life Cycle

  • A mature or adult head louse can lay up to 10 eggs or nits each day.
  • These nits, or lice eggs, hatch in about 7 to 12 days. Baby lice or nymphs are about the size of a pinhead when they hatch and quickly mature into adult lice in about a 9 to 12 days.
  • In just a few days, adult lice are ready to mate, starting this lice life cycle all over again during their 3- to 4-week lifespan.

Of course, a proper lice treatment regimen can interrupt the lice life cycle and help you get rid of the lice on your child’s hair.


Edmond Hooker, MD, DrPH

Dr. Eddie Hooker is currently an Assistant Professor in the Department of Health Services Administration at Xavier University in Cincinnati, Ohio. He is also an Associate Clinical Professor in the Department of Emergency Medicine at the University of Louisville and at Wright State University. His areas of expertise include emergency medicine, epidemiology, health-services management, and public health.

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Head lice facts

  • Head lice are parasites that are found on human heads. The word lice is plural for louse.
  • Head lice spread from person to person by head-to-head contact through direct contact with the hair of an infested person. Although less common, head lice can spread by personal contact or the sharing of combs, brushes, caps, and other clothing.
  • Head lice are a common problem with preschool and elementary school-aged children.
  • Head lice cause a tickling feeling of something moving in the hair, itching, and sores on the head.
  • The affected indiv >

Head Lice Symptoms

Although itching may be a sign of a lice infestation, most often individuals are asymptomatic. Keep in mind that although the only reliable sign of an infestation is the presence of a live louse or nymph (juvenile louse), the presence of nits may be a sign that there is or has been an active infestation.

What are head lice?

Head lice (Pediculus humanus capitis) are parasites that can be found on the heads of people. Pediculosis is the term for an infection with head lice. (The head louse, Pediculus humanus capitis, is different from the pubic louse (Pthirus pubis), which causes pubic hair infections, and the body louse (Pediculus humanus corporis).

How common is head lice infestation?

Head lice infestation is very common, and it has been around since ancient times. While the exact frequency of infections is unknown, estimates range from 6-12 million cases annually.

Who is at risk for getting head lice?

Anyone who comes in close contact with someone who already has head lice, or even their contaminated clothing and other belongings, is at risk for acquiring head lice. So it is easy to transmit head lice from one person to another. Preschool and elementary-school children (3-11 years of age) and their families are infected most often. Girls contract head lice more often than boys, and women contract more head lice than men.

How in the world does a child get head lice?

A child can contract head lice in a number of ways.

  • Contact with an already infested person (Personal contact is common during play, school, or sports activities, and at school, home, slumber parties, or camp.)
  • Wearing infested clothing, such as hats, scarves, coats, sports uniforms, or hair ribbons
  • Using infested combs, brushes, or towels
  • Lying on a bed, couch, pillow, carpet, or stuffed animal that has recently been in contact with a person with lice (though there is evidence that the risk is very low if more than 48 hours has passed since the exposure)

Does getting an infection with head lice mean that the person has poor hygiene?

No. Getting a head lice infection has nothing to do with personal hygiene. Anyone can become infested with head lice.

What do head lice look like? What is the life cycle of head lice?

There are three forms of lice, namely the nit, the nymph, and the adult louse.

Nit: Nits are lice eggs. Nits are hard to see and are often confused with dandruff or hair-spray droplets. Nits are found firmly attached to the hair shaft. They are oval shaped, 2-3 mm in length and usually yellow to white in color. Nits take about a week to hatch.

Nymph: The nit hatches into a baby louse called a nymph. It looks like an adult head louse but is smaller. Nymphs mature into adults about seven days after hatching. To live, the nymph must feed on human blood.

Adult: The adult louse is about the size of a sesame seed, has six legs, and is tan to grayish-white in color. In people with dark hair, the adult louse looks darker. Females lay nits; they are usually larger than males. Adult lice can live up to 30 days on a person’s head. To live, adult lice need to feed on human blood. If the louse falls off a person, it dies within two days.

Life cycle: The nits hatch into nymphs, which become full grown lice. In order to produce more nits, the adult lice must mate.

Where are head lice most commonly found?

Head lice are most frequently located on the scalp behind the ears and near the neckline at the back of the neck. Head lice hold on to hair with hook-like claws that are found at the end of each of their six legs. Head lice are rarely found on the body, eyelashes, or eyebrows.

Head lice vs. dandruff

Head lice are often confused with dandruff. Dandruff can easily be distinguished by combing the hair or even just rubbing. Dandruff should be easily removed, but the nits of head lice are firmly attached to the hair shaft.

What are the signs and symptoms of head lice infestation?

The signs and symptoms are

  • a tickling feeling of something moving in the hair;
  • itching (caused by the an allergic reaction to the bites);
  • sores on the head (caused by scratching);
  • these sores on the head can sometimes become infected;
  • irritability.

How is a head lice infestation diagnosed?

Head lice can be detected by looking closely through the hair and scalp for nits, nymphs, or adults. Locating a nymph or adult may be difficult; there are usually only a few of them, and they can move quickly from searching fingers. However, the presence of nits close to the scalp confirms that a person is infested. If the nits are located more than ¼ inch from the scalp, the infestation is probably an old one. If you are not sure whether or not a person has head lice, the diagnosis should be made by a health care professional, school nurse, or a professional from the local health department or agricultural extension service. The nits of head lice are easily visible with a microscope. Dr. Ioffe-Uspensky performed a study that showed that using a louse comb was better than visual inspection alone when screening for lice infestations.

Does a black light help to diagnose lice infections?

A black light is sometimes used to see if there are nits with live lice in them. Some reports indicate that nits with live lice will fluoresce.

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What is the treatment for a head lice infestation (pediculosis)?

For effective elimination of head lice, the infested individual, family members that are also infested, and the home must all be treated. It is important to remember that treatment should only be started if there are clearly live lice identified. According to the American Academy of Pediatrics in a recent clinical report, “The ideal treatment of lice should be safe, free of toxic chemicals, readily available without a prescription, easy to use, effective and inexpensive.”

Treatment of the individual and the infested family members

Over-the-counter (OTC) or prescription medications are used to treat the affected people and their families. Follow these treatment steps:

  1. Remove all clothing.
  2. Apply lice-killing medicine, also called pediculicide, according to the label instructions. If a child has extra-long hair, one may need to use a second bottle. Warning: Do not use a cream rinse or combination shampoo/conditioner before using lice medicine. Do not rewash hair for one to two days after treatment.
  3. Have the infested person put on clean clothing after treatment.
  4. If some live lice are still found eight to 12 hours after treatment but are moving more slowly than before, do not retreat. Comb dead and remaining live lice out of the hair using a fine-toothed comb (lice comb). The medicine sometimes takes longer to kill the lice.
  5. If no dead lice are found and lice seem as active as before eight to 12 hours after treatment, the medicine may not be working. See a health care professional for a different medication and follow their treatment instructions.
  6. Nit (head lice egg) combs, often found in lice medicine packages, should be used to remove nits and lice from the hair shaft. Many flea combs made for cats and dogs are also effective.
  7. After the initial treatment, check, comb, and remove nits and lice from hair every two to three days.
  8. Retreat in seven to 10 days.
  9. Check all treated people for two to three weeks until you are sure all lice and nits are gone.

What is the treatment for a head lice infestation (pediculosis)? (Continued)

Treating the house

Treating the whole house is a laborious but important task. Follow these steps:

  1. Machine wash all washable clothing and bed linens that the infested person touched during the two days before treatment (to kill the lice and nits). Use the hot water cycle (130 F; 55 C) to wash clothes. Dry laundry using the hot cycle for at least 20 minutes.
  2. Dry clean clothing that is not washable (coats, hats, scarves, etc.), or store all clothing, stuffed animals, comforters, etc., that cannot be washed or dry cleaned into a plastic bag and seal it for two weeks. (By this time, any nits that have survived will have hatched and the nymphs would die without a feeding source.)
  3. Soak combs and brushes for one hour in rubbing alcohol, Lysol, or wash with soap and hot (130 F; 55 C) water and then place in bag and leave in freezer for two days.
  4. Vacuum the floor and furniture. Do not use fumigant sprays. (They can be toxic if inhaled.)

My child has head lice. I don’t. Should I treat myself to prevent being infested?

No. Although anyone living with an infested person can get head lice, you don’t need to be treated. Check household contacts for lice and nits every two to three days. Treat if lice and nits are found.

Should my pets be treated for head lice?

No. Head lice do not live on pets.

My child is under 2 years of age and has been diagnosed with head lice. Can I treat my child with prescription or over-the-counter (OTC) drugs?

For children under 2 years old, remove nits, nymphs (immature adult lice), and adult lice by hand, and see a health care professional. Permethrins are approved for children older than 2 months of age; however, this should too be done after consultation with your physician.

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What OTC medications are available to treat head lice?

Many head lice medicines are available at drugstores. Each OTC product usually contains one of the following active ingredients:

  1. Pyrethrins (often combined with piperonyl butoxide, in brand name products: A-200, Pronto, R&C, RID, Triple X): Pyrethrins are natural extracts from the chrysanthemum flower. Though safe and effective, pyrethrins are not ovicidal (egg-killing) and can only kill crawling lice, not unhatched nits. It is applied to dry hair and allowed to remain for 10 minutes but no longer. After 10 minutes, the hair should be brought to a lather with warm water and then rinsed clear. Finally, towel dry (no hair dryer). A second treatment is recommended in seven to 10 days to kill any newly hatched lice. Treatment failures are common due to, in part, the development of resistance. They should not be used in people allergic to chrysanthemum or ragweed. Pyrethrins are approved for use on individuals 2 years of age or older.
  2. Permethrins 1% (NIX): Permethrins are similar to natural pyrethrins. Permethrins were introduced in 1986 and are safe and effective and may continue to kill newly hatched eggs for several days after treatment. The person should first wash their hair using a shampoo without a conditioner and towel dry the hair until it is still damp but not soaking wet. Apply the NIX to the damp hair and scalp. Make sure to get behind the ears and neck. Leave NIX in hair for 10 minutes but no longer. Rinse hair completely and towel dry. A second treatment may be needed in seven to 10 days to kill any newly hatched lice. Treatment failures are common, but NIX can be used on children as young as 2 months of age.
  3. Dimethicones (LiceMD, silicone oils, Hedrin, NYDA): Dimethicones are a type of silicone oil. These products are believed to work by coating surfaces and acting as a physical barrier that asphyxiates the louse. Unfortunately, there has been very limited research on their effectiveness. Nevertheless, some limited studies have shown moderately good rates of killing the lice. These dimethicones are biologically inert and are considered non-toxic in humans. In the United Kingdom, they are used almost exclusively, and they are considered highly effective by many physicians.
  4. Other agents: There are a number of other agents that have been used to treat lice. Some agents mix coconut oil and tea tree oil with permethrins or pyrethrins. It is not clear if these agents work alone or only in combination with other pediculocides. Other home remedies include using olive oil, mayonnaise, and even vinegar. However, there are no studies proving their efficacy.

What prescription drugs treat head lice?

Malathion .5% (Ovide): Malathion is an organophosphate insecticide that is only available as a prescription and it kills live lice (pediculicidal) and the lice inside the eggs/nits (ovicidal). It has actually been pulled off the market twice due to safety concerns, but it was reintroduced in the United States (USA) in 1999 due to increasing resistance of head lice to other treatments. The formulation in the United States contains terpineol dipentene, isopropyl alcohol, and pine needle oil, both of which have pediculicidal properties. The product is used differently than other compounds. The product is extremely flammable and should never be around heat, hair dryers, or curling irons. The product is applied to dry hair until the scalp and hair are thoroughly coated. Make sure that the area behind the ears and the back of the neck are covered. Let the hair dry naturally (no hair dryers). The product is left in place for eight to 12 hours. After eight to 12 hours, wash and rinse the hair with shampoo. Use a nit comb (fine-toothed comb) to remove any nits. If live lice are noted after seven days, retreat. It is currently recommended only for individuals 6 years of age up to 60 years of age.

Benzyl alcohol 5% (Ulesfia): Benzyl alcohol is available in the U.S. as a 5% lotion. The product is applied to dry hair until the scalp and hair are thoroughly coated. Make sure that the area behind the ears and the back of the neck are covered. Leave it in the hair for only 10 minutes and then rinse thoroughly in a sink. Do not use a shower to avoid getting the solution over the rest of the body. You can immediately wash your hair with regular shampoo. It is not ovicidal and needs to be repeated in one week if there is any evidence of live lice.

Spinosad (Natroba): Spinosad is a derived from soil bacteria. It is both pediculicidal (kills the live lice) and ovicidal (kills the lice inside the eggs/nits). It is moderately more effective than the over-the-counter treatments but is available only by prescription and is very expensive. If live lice are noted after seven days, retreat. It is approved in children 6 months of age and older and contains benzyl alcohol, as well.

Ivermectin (Sklice): Ivermectin is available as both a 0.5% lotion (which is FDA approved for the treatment of lice) and as an oral medication (which is not approved in the U.S. for treatment of lice). It has been used to treat helminthic infestations (worms) for many years. Generally, only one treatment is needed. It is pediculocidal (kills live lice). Although it is not ovicidal (kills the lice inside the eggs/nits), it appears to prevent nymphs (newly hatched lice) from surviving. Topical ivermectin lotion may be used in the treatment of lice in children 6 months of age and older. While oral invermectin is commonly used in other countries for lice, it is currently not approved for the treatment of head lice in the U.S. In countries where it is approved, the dosage is usually a single dose, which is often repeated in nine days.

Lindane (Kwell): It is important to note that lindane 1% (Kwell) is no longer recommended as a treatment option for head lice due to its toxicity in children. It can still be prescribed, but most experts recommend against its usage.

Other treatments such as permethrin 5%, crotamiton 10%, and sulfamethoxazole-trimethoprim (Bactrim) are not currently approved by the FDA for the use in the treatment of head lice.


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