What does head lice mean in children?

A child may scratch the scalp, complain of a crawling sensation, or have no symptoms at all. Nits are firmly attached to hairs, often near the scalp, while dandruff and lint are easier to dislodge. Head lice are not a sign that a child is dirty, and they do not live by jumping or flying.

A diagnosis is stronger when live crawling lice are found. Avoid assuming that every itchy scalp is head lice; examine the hair carefully or arrange a clinical check. More background is available in [Head Lice](/conditions/head-lice/).

Check the child in bright light with damp, conditioned hair. Divide the hair into sections and comb from the scalp outward with a fine-toothed comb, wiping it after each pass. Check household members and avoid sharing combs, brushes, hats, pillows, and hair accessories while the situation is assessed. If live lice are found, use a product and schedule suited to the child’s age, following the instructions exactly.

Ask a healthcare professional to assess the child when you cannot confirm live lice, the child is very young, previous treatment has not worked as expected, or scratching has broken the skin. Seek prompt advice for fever, pus, spreading redness, marked swelling, or worsening pain. Do not use household insecticides or strong oils on a child’s scalp.

Ask how the diagnosis was confirmed, which treatment is suitable for the child’s age, when to repeat checking, and which contacts also need inspection.