How to check for lice on yourself?

Understanding Head Lice

What Are Head Lice?

Head lice (Pediculus humanus capitis) are obligate ectoparasites that live on the human scalp. Adult insects measure 2–3 mm in length, have a flattened body, six legs, and a gray‑white to brown coloration that blends with hair. The life cycle includes egg (nit), nymph, and adult stages, each requiring blood meals from the host. Eggs are cemented to the hair shaft near the scalp and hatch within 7–10 days; nymphs mature in an additional 9–12 days.

Infestation produces persistent itching caused by allergic reactions to saliva injected during feeding. Visible signs include live insects moving quickly across the scalp and nits attached at a 45‑degree angle to hair strands. Nits appear as tiny, oval, translucent or grayish dots; they become darker as embryos develop.

Transmission occurs primarily through direct head‑to‑head contact, which enables mobile lice to move between hosts. Indirect spread via combs, hats, or bedding is possible but less common because lice cannot survive long without a blood source.

Key characteristics for identification:

Size: 2–3 mm (adult), 0.8 mm (nymph)
Color: gray‑white to brown; nits initially translucent, later darkened
Attachment: nits fixed at an angle to the hair shaft, within ¼ inch of the scalp
Mobility: adults move rapidly, especially when the host is disturbed
Habitat: hair on the scalp, behind ears, at the nape of the neck

Understanding these biological and visual traits equips anyone performing a personal lice inspection with the necessary criteria to recognize an active infestation promptly.

Common Symptoms of Infestation

Itching that worsens after heat exposure, especially around the scalp, neck, and ears, indicates the presence of active lice. Small, white or yellowish oval structures attached to hair shafts—commonly called nits—are visible when the hair is examined closely. These nits appear at the base of the hair shaft and do not easily wash away; they may be mistaken for dandruff but remain firmly fixed. Red, irritated patches or tiny sores develop from repeated scratching, sometimes accompanied by secondary bacterial infection. A faint, musty odor may be detected when the hair is compressed, reflecting the secretions of the insects.

Persistent scalp itching, particularly after showering or washing hair
Nits positioned within a half‑centimeter of the scalp, often in clusters
Live lice, approximately 2–4 mm in length, moving rapidly across the scalp surface
Small, raised lesions or sores caused by scratching
Unusual odor emanating from the hair or scalp

Identifying these signs during a personal inspection allows prompt treatment and prevents further spread.

Lice vs. Dandruff or Other Scalp Conditions

When inspecting your scalp, focus on visual and tactile clues that separate live insects from harmless flakes or skin disorders. Live lice appear as small, elongated insects about the size of a sesame seed, usually attached to hair shafts close to the scalp. Their bodies are grayish‑brown, and they move when disturbed. Nits (lice eggs) are oval, about 0.8 mm long, firmly glued to the hair shaft at a 45‑degree angle, often near the crown or behind the ears. A gentle pull on a strand will reveal a solid, immobile nodule if a nit is present.

Dandruff consists of white or yellowish scales that detach easily and fall onto clothing. The flakes are not attached to hair shafts and lack a solid base. Scalp psoriasis produces silvery, thicker plaques that may bleed when scraped, while seborrheic dermatitis yields greasy, yellowish patches that emit a mild odor. Neither condition presents moving organisms or firmly attached oval bodies.

Key differences for self‑examination:

Mobility: lice move; flakes and plaques are static.
Attachment: nits are glued at an angle; dandruff and psoriasis flakes are loose.
Size and shape: lice are elongated insects; nits are oval; dandruff flakes are irregular, larger, and translucent.
Reaction to touch: lice may crawl away; skin conditions may cause itching but not movement.

Accurate identification relies on close inspection with a fine-tooth comb under bright light. If live insects or firmly attached nits are observed, treatment for lice is required; otherwise, the symptoms indicate a non‑parasitic scalp condition that warrants dermatological care.

Preparing for Self-Examination

Gathering Necessary Tools

Fine-toothed Comb or Lice Comb

The fine‑toothed or lice comb is the most reliable instrument for personal detection of head‑lice infestations. Its densely spaced teeth, typically 0.2–0.3 mm apart, capture nymphs and adult insects while allowing hair to pass through.

Prepare the area by selecting bright, natural light or a lamp positioned directly above the scalp. Dampen the hair with water or a conditioner to reduce slip; this enhances the comb’s grip on parasites. Use a clean, dry towel to prevent excess moisture from obscuring visibility.

Section the hair into 1‑inch strips, starting at the crown and moving outward.
Place the comb at the scalp, pull it gently toward the tip in a smooth motion.
After each pass, wipe the teeth on a white paper towel to expose any captured lice or nits.
Repeat the process on each section, ensuring every strand is examined at least twice.
Re‑examine the base of the neck and behind the ears, common hiding spots.

After inspection, soak the comb in hot water (minimum 130 °F/55 °C) for ten minutes, then rinse with soap and dry thoroughly. Store the tool in a sealed container to avoid re‑contamination.

If no parasites are found but itching persists, consider a secondary method such as visual scalp inspection with a magnifying lens or a professional evaluation. The comb remains the cornerstone of self‑screening, providing immediate, tangible evidence of infestation.

Good Lighting

Good lighting reveals lice and nits that are otherwise hidden. Bright, magnified illumination separates the parasite’s dark body from hair strands, allowing accurate visual confirmation.

Ideal conditions include natural daylight or a high‑intensity white lamp positioned a few inches from the scalp. The light source should be at a 45‑degree angle to reduce glare and cast shadows that obscure small objects. A handheld magnifier with built‑in LED lights provides additional detail for close inspection.

Practical steps:

Choose a well‑lit area, preferably near a window or under a daylight‑balanced lamp.
Position a magnifying device so the hair is flat and evenly illuminated.
Scan each section of the head systematically, moving the light source to maintain consistent brightness.
Verify any suspected particles by enlarging the view; lice appear as gray‑brown insects, while nits are oval, firmly attached to the hair shaft.

Consistent use of proper illumination minimizes false negatives and speeds up the detection process.

Magnifying Glass

A magnifying glass is a practical tool for personal lice detection. Its convex lens enlarges the scalp surface, allowing clear observation of individual nits and adult insects that are often missed by the naked eye.

When inspecting the hair, follow these steps:

Choose a lens with at least 3× magnification; higher power provides finer detail but may reduce field of view.
Position the light source behind or above the head to eliminate shadows.
Part the hair into small sections, holding the glass a few centimeters from the scalp.
Scan each section slowly, looking for:
- Oval, white or yellowish nits attached firmly to the hair shaft within ¼ inch of the scalp.
- Small, brownish insects measuring 2–4 mm, moving quickly when disturbed.
Record any findings and repeat the process on the entire head, including behind the ears and at the nape.

A quality magnifying glass should have an anti‑reflective coating to minimize glare and a comfortable grip for steady handling. Portable pocket versions enable quick checks in public spaces, while larger tabletop models are suited for thorough home examinations.

Regular self‑inspection with a magnifier, combined with proper hygiene, reduces the risk of unnoticed infestations and facilitates early treatment.

White Towel or Cloth

A white towel or cloth serves as a practical tool when inspecting your scalp for lice. Its light color highlights any insects or eggs that might be missed on darker fabrics, allowing quick visual confirmation.

Place the towel on a flat surface and lay a small section of hair on it, separating strands with your fingers. Use a fine-toothed comb to pull through the hair while the towel catches any detached nits or live lice. Examine the towel under adequate lighting; the contrast makes translucent nits and dark insects stand out.

Advantages of a white towel or cloth include:

Immediate visibility of debris, reducing the risk of overlooking infestations.
Easy cleaning; the fabric can be laundered at high temperature after each use.
Portability; a small piece of cloth fits in a travel kit for on‑the‑go checks.

For thorough inspection, repeat the process on all sections of the head, moving the towel after each pass to prevent cross‑contamination. Dispose of or wash the towel promptly to eliminate any retained parasites.

Hair Clips or Ties

Hair clips and ties are practical tools during a personal lice inspection. Secure the hair with a clip or elastic band to separate sections, creating a clear view of the scalp and strands. This method reduces the amount of hair that must be examined at once, allowing a focused search for live insects or nits attached close to the root.

When using clips or ties, follow these steps:

Choose a small, sturdy clip or a tight elastic that will not slip.
Part the hair at the crown, behind the ears, and at the nape of the neck.
Apply the clip to hold the upper layer while you scan the exposed section with a fine-tooth comb.
Move the clip along the hair line, releasing and re‑securing as you progress.
After each pass, inspect the comb teeth for lice or eggs; discard any found immediately.
Clean the clip or tie with hot, soapy water after the inspection to prevent re‑infestation.

Proper use of hair clips or ties streamlines the examination process, minimizes the risk of missing hidden nits, and simplifies post‑inspection sanitation.

Choosing the Right Environment

Choosing an appropriate setting is essential for accurate self‑inspection of head lice. A well‑lit, calm space reduces the chance of missing nits or adult insects.

First, select a room with natural daylight or a bright lamp positioned at a 45‑degree angle to the scalp. Direct light highlights the translucent shells that cling to hair shafts. Second, ensure the temperature is comfortable; excessive heat can cause sweating, which obscures visibility and may irritate the scalp. Third, eliminate background distractions. Turn off televisions, radios, and mobile devices to maintain focus on the inspection process.

A practical checklist for the environment:

Lighting: daylight or a white LED lamp, no shadows on the head.
Seating: a stable chair with a backrest; avoid reclining positions that tilt the head.
Mirror: a full‑length or handheld mirror with a clear, unblemished surface.
Tools: a fine‑toothed comb placed nearby, a clean surface for laying extracted specimens.
Cleanliness: wipe the area with a disinfectant wipe before beginning to prevent cross‑contamination.

Finally, conduct the examination after a recent wash, when hair is dry and free of styling products that could mask lice. Performing the inspection in the described environment maximizes detection rates and supports effective treatment planning.

Understanding the Life Cycle of Lice

Nits (Eggs)

Nits are the immobile eggs laid by head‑lice and remain attached to the hair shaft for about 7–10 days before hatching. They appear as tiny, oval structures, typically 0.8 mm in length, and are most often found close to the scalp where temperature supports development. The shell is translucent to tan, and the egg interior may be visible as a dark dot. Unlike live lice, nits cannot move; they cling firmly with a cement‑like secretion.

To locate nits during a self‑examination, follow these steps:

Use a fine‑toothed comb (preferably a nit‑comb with 0.2 mm spacing) on dry hair.
Section the hair into 1‑inch sections, starting at the crown and moving outward.
Comb each section from the scalp outward, wiping the comb on a white tissue after each pass.
Examine the tissue for tiny, oval specks attached to the hair near the scalp.
Repeat the process on the sides, back, and nape, paying special attention to the posterior hairline and behind the ears.

If nits are present, they will be firmly attached; gentle pulling with the comb will not detach them. Removal requires repeated combing over several days, as newly hatched lice may lay additional eggs. For thoroughness, inspect the entire scalp surface, including hair behind the ears, the neck, and any accessories that hold hair close to the skin.

Nymphs (Young Lice)

Nymphs are the immature stage of head lice that appear shortly after eggs hatch. They measure 1–2 mm, are translucent or pale yellow, and lack the hardened exoskeleton of adult lice. Because of their size and color, nymphs blend with hair shafts and can be missed without careful inspection.

Detecting nymphs early prevents a population from reaching reproductive maturity, which reduces the total number of lice and shortens the infestation period. Their presence also indicates that eggs have recently hatched, signaling that treatment must address both live insects and unhatched eggs.

Key visual cues include:

Small, whitish bodies moving slowly along hair strands.
Absence of visible eggs (nits) attached near the scalp.
Slightly shorter legs compared to adult lice.

Effective self‑examination follows these steps:

Choose a well‑lit area; natural daylight or a bright lamp provides the best contrast.
Part hair close to the scalp with a fine‑toothed comb, working from the crown toward the forehead.
Inspect each section with a magnifying glass at 10–15× magnification.
Look for moving specks or stationary pale bodies on the hair shaft, especially behind the ears and at the nape.
If a nymph is found, capture it with a tissue and note its location for treatment focus.

After spotting nymphs, apply an approved lice treatment to the entire scalp, repeat the combing process after 7–10 days to remove any newly hatched nymphs, and wash clothing and bedding at high temperature to eliminate residual eggs. Continuous monitoring for at least two weeks ensures the infestation does not recur.

Adult Lice

Adult head lice are the mature stage of the parasite, measuring about 2–3 mm, with six legs and a flattened, elongated body. They cling to hair shafts close to the scalp, where temperature and moisture support feeding. Unlike nymphs, adults are sexually mature and capable of laying up to eight eggs per day.

Detecting an infestation requires systematic visual inspection. Begin with a well‑lit area, preferably natural daylight or a bright lamp, and part the hair in sections of 1–2 cm. Examine each section from the scalp outward, looking for live insects, which appear as brownish or grayish specks, and for movement. A magnifying glass or a handheld loupe can improve visibility, especially on dark hair.

Effective self‑screening incorporates a fine‑tooth comb designed for lice detection. Follow these steps:

Wet hair and apply a generous amount of conditioner to reduce slip.
Run the comb from the scalp to the ends, pausing after each pass to inspect the teeth for captured lice.
Wipe the comb on a white tissue or paper after each pass; adult lice are visible as distinct, elongated bodies.
Repeat the process on all sections, including behind the ears and at the nape of the neck.

If adult lice are observed, isolate the infested hair region, note the number of insects, and proceed with appropriate treatment. Absence of visible adults after thorough combing and inspection indicates no current infestation. Regular monthly checks, especially after close contact with others, maintain early detection and prevent spread.

The Self-Examination Process

Sectioning Your Hair

Dividing the hair into manageable sections creates a clear view of each scalp area, allowing precise inspection for nits and adult lice. Use a fine‑tooth comb or a clean hair clip to separate strands, beginning at the crown and working outward. This method reduces the chance of missing hidden insects that blend with dense hair.

Procedure for effective sectioning

Choose a clean, well‑lit environment; natural daylight or a bright lamp provides optimal contrast.
Part the hair into 1‑inch (2‑cm) sections, securing each with a small clip or elastic band.
Starting at the forehead, pull the section taut and run a lice detection comb from the scalp to the ends, examining the comb teeth after each pass.
Release the clip, move to the adjacent section, and repeat until the entire head has been examined.
After each section, place any found nits on a white tissue for confirmation; discard them promptly.

Consistent sectioning ensures thorough coverage, minimizes oversight, and speeds the detection process, making self‑examination reliable and repeatable.

Systematic Combing Technique

Starting at the Scalp

Begin the inspection at the scalp, where adult lice attach and lay eggs. Use a bright light and a fine‑toothed comb or a magnifying lens to improve visibility.

Prepare the area by:

Selecting a well‑lit space or a lamp with adjustable brightness.
Wetting the hair briefly with water or a light conditioner to slow the insects and reduce glare.
Securing a clean comb or a lice detection device on a stable surface.

Conduct the examination as follows:

Separate a small section of hair close to the roots with a fingertip or a clip.
Run the comb from the scalp outward, moving slowly to catch any nits or live lice.
Observe the comb teeth after each pass; live lice appear as brownish, mobile insects, while nits cling firmly to hair shafts and resemble tiny, oval, yellow‑white specks.
Repeat the process across the entire scalp, working from the front hairline to the nape, and from one ear to the other.

After completing the scan, wipe the comb on a paper towel and discard any captured specimens. If any lice or nits are found, initiate treatment promptly; otherwise, repeat the self‑check weekly for at least three weeks to confirm the absence of infestation.

Combing Down to the Ends

Combing hair from the scalp to the tips provides the most reliable visual confirmation of infestation. The fine-tooth lice comb isolates both adult insects and attached eggs, which are often missed when only the roots are examined.

Wet hair thoroughly; moisture reduces slip and improves comb grip.
Apply a generous amount of conditioner to detangle and keep strands together.
Position the lice comb as close to the scalp as possible; pull a small section of hair taut.
Drag the comb through the entire length of the strand, moving from the root toward the tip in a single, smooth motion.
After each pass, wipe the comb on a white tissue or rinse in running water to reveal any captured organisms.
Repeat the process for each section, overlapping slightly to ensure complete coverage.

Inspect the combed material for live insects and for nits firmly attached to the shaft within a quarter‑inch of the scalp. A single detection warrants immediate treatment and a repeat inspection after 7–10 days to catch newly hatched lice. Clean the comb with hot, soapy water after each use to prevent cross‑contamination.

Wiping the Comb After Each Stroke

When inspecting your scalp for lice, each pass of the comb must be followed by a clean wipe. Residual hair, debris, or any captured insects can obscure the next examination area and lead to false‑negative results.

After pulling the comb through a section, tap it gently over a white surface.
Use a disposable paper towel or tissue to rub the teeth, removing any nits or lice.
Inspect the removed material immediately; a magnifying lens can help confirm the presence of parasites.
Discard the used wipe in a sealed bag to prevent re‑contamination.
Continue the process with a fresh comb or a re‑cleaned one for each new section of hair.

This routine ensures that each stroke evaluates a clean segment of scalp, maximising detection accuracy and reducing the risk of overlooking hidden infestations.

Focusing on Common Infestation Areas

Behind the Ears

Inspecting the area behind the ears is essential because head lice often hide in this warm, concealed spot. Follow these precise steps:

Part the hair at the base of the skull using a fine‑toothed comb or a clean fingertip.
Pull the hair away from the skin to expose the scalp surface.
Examine the skin and hair shafts directly behind each ear, looking for live insects (approximately 2–4 mm, gray‑brown), nymphs, or translucent eggs firmly attached to the hair shaft.
Use a magnifying lens if available to verify the characteristic oval shape of lice eggs (nits) and the brownish body of adult lice.
Run the comb from the hair root to the tip, collecting any detached insects or nits on a white paper towel for easier identification.

Key indicators of infestation in this region include:

Small, moving insects crawling near the hair roots.
White or yellowish oval structures attached at a 45‑degree angle to the hair shaft.
Persistent itching or irritation localized behind the ears.

If any of these signs appear, repeat the examination daily for three consecutive days and consider treatment according to medical guidelines.

Nape of the Neck

Inspecting the nape of the neck is essential when performing a personal lice assessment. This area often harbors the greatest concentration of eggs because hair is short and close to the scalp, providing a protected environment for infestations.

The nape requires careful examination due to its curvature and the tendency of hair to lie flat against the skin, which can conceal nits. A thorough check reduces the risk of missing early signs and prevents spread to other regions.

Inspection steps

Position a bright light source directly above the back of the head.
Separate hair at the nape using a fine‑tooth comb, pulling strands away from the skin.
Scan each section from the scalp outward, looking for oval, yellow‑white structures firmly attached to hair shafts.
Pause on any found items; move the comb slowly to verify whether they are firmly glued (nits) or loose (cattle‑eggs).
Repeat the process on both sides, ensuring full coverage of the entire nape.

Tools and conditions

Use a metal lice comb with teeth spaced 0.2 mm apart.
Conduct the examination on a clean, dry scalp; moisture can obscure visibility.
Perform the check in a well‑ventilated area to avoid irritation from close proximity to the head.

Indicators of infestation

Nits attached within ¼ inch of the scalp, appearing as translucent or brownish ovals.
Live lice, typically 2–3 mm long, moving rapidly when hair is disturbed.
Persistent itching localized to the nape, often accompanied by small red bumps.

If any nits or lice are detected, initiate treatment promptly and repeat the nape inspection after 7–10 days to confirm eradication. Continuous monitoring of this region remains a reliable method for early detection and control.

Crown of the Head

The crown of the head is a common site for head‑lice infestation because hair density and warmth create an ideal environment for nits and insects. Inspecting this area requires a systematic approach to ensure no egg or adult is missed.

Begin by securing a bright light source and a fine‑toothed lice comb. Part the hair on the crown into sections no wider than one inch. Run the comb from the scalp outward, moving slowly to capture any attached nits. After each pass, wipe the comb on a white tissue to reveal hidden specimens. Repeat the process until the entire crown has been examined.

Key points for an effective self‑inspection of the crown:

Use a magnifying glass if available to improve visibility of tiny nits.
Examine the hair close to the scalp; nits are typically attached within ¼ inch of the skin.
Perform the check on a dry scalp; wet hair can obscure eggs.
Conduct the examination on a regular schedule, such as weekly, to detect early infestations.

What to Look For

Live Lice

Live lice are small, wingless insects that feed on human blood. Adult females measure 2–4 mm, are tan to gray, and lay eggs (nits) firmly attached to hair shafts. Nymphs resemble adults but are smaller and develop through three molts before reaching maturity. Their movement is rapid; they can be seen crawling on the scalp, behind the ears, and near the neck.

Detecting an active infestation requires a visual and tactile examination. Live insects indicate an ongoing problem, whereas only nits may persist after treatment. Accurate identification prevents unnecessary medication and guides appropriate intervention.

Part hair into small sections using a fine-tooth comb.
Examine each section against a bright light source.
Look for mobile insects moving quickly on the scalp or hair shaft.
Feel for itching or a tickling sensation while parting hair.
Inspect the nape, behind ears, and at the hairline, where lice concentrate.

A hand-held magnifier (10×) improves visibility of tiny adults and nymphs. Wet the hair with a light spray of conditioner to immobilize lice, then repeat the combing process. After each pass, wipe the comb on a white tissue to confirm the presence of live insects.

If live lice are observed, treat immediately with an approved pediculicide and repeat the combing procedure daily for at least seven days to break the life cycle. Absence of movement after thorough inspection suggests the infestation has been cleared.

Nits (Eggs) Attached to Hair Shafts

Nits are oval, firm structures about 0.8 mm in length that adhere tightly to the hair shaft near the scalp. The attachment point is cemented with a proteinaceous substance, making the egg immobile and resistant to brushing. Viable nits appear white or yellowish and are often positioned within ¼ inch of the scalp, where temperature supports development.

Visual identification requires clear illumination and magnification. A bright, direct light source eliminates shadows that can mask tiny eggs. A handheld magnifier at 10‑20× enlarges the hair shaft, revealing the characteristic dome‑shaped cap of a nit and the smooth, translucent body beneath. The egg’s surface may show a faint brown or gray hue as it ages.

Effective tools include:

Fine‑tooth nit comb with teeth spaced 0.2 mm apart.
Disposable magnifying glass or loupes.
LED lamp or daylight lamp for consistent lighting.

Procedure for self‑inspection:

Secure hair away from the face using a hair tie or clip.
Apply a small amount of conditioner to soften the hair and reduce cling.
Starting at the nape, run the nit comb through a 2‑inch section, pulling from scalp to tip.
After each pass, wipe the comb on a white tissue to expose captured material.
Examine the tissue under magnification; white, oval objects attached to hair fragments indicate nits.
Repeat the process across the entire scalp, focusing on behind ears, the crown, and the hairline.

Differentiating nits from dandruff or hair debris relies on attachment. Dandruff flakes detach easily when the hair is brushed, while nits remain fixed to the shaft. A nit’s surface is smooth and glossy, unlike the flaky, powdery texture of skin scales.

If nits are confirmed, immediate removal with the nit comb and treatment with an approved pediculicide are recommended. Follow‑up inspections at 7‑day intervals ensure that any newly hatched lice are detected before they lay additional eggs.

Empty Eggshells (Casings)

Empty eggshells, commonly called casings or nits, are the translucent, oval remnants left after a louse egg hatches. They cling tightly to the hair shaft, usually within 1 mm of the scalp, and appear as pale, smooth shells that may be mistaken for dandruff or hair debris. Recognizing these structures is essential for an accurate self‑inspection.

When scanning the scalp, focus on the following regions, where lice and their eggs concentrate:

Neck and behind the ears
Crown and parting lines
Sideburns and under the chin

Use a magnifying lens or a well‑lit mirror to enhance visibility. A fine‑tooth lice comb, run slowly from the root toward the tip, will capture any shells that remain attached. After each pass, wipe the comb on a white tissue; a single shell is easily distinguished by its oval shape and lack of a solid interior.

To differentiate empty shells from other particles:

Empty shells are slightly larger than typical dandruff flakes (about 0.8 mm).
They remain affixed to the hair strand even after gentle brushing.
Their surface is smooth and glossy, lacking the fibrous texture of skin scales.

If shells are detected, repeat the combing process on dry hair for at least ten minutes, then wash the hair with hot water and a lice‑specific shampoo. Continue daily inspections for a week to ensure no additional eggs hatch.

What to Do After Finding Lice

Confirming the Infestation

Detecting a lice infestation requires systematic visual inspection and tactile verification. Begin by separating hair into small sections, using a fine-toothed comb or a specialized lice detection comb. Run the comb from scalp to tip, wiping each pass onto a white tissue or a damp paper towel. Observe the comb for live insects, dead bodies, or translucent oval eggs (nits) attached firmly to hair shafts.

Key indicators of infestation include:

Live lice: brownish, wingless insects, approximately 2–3 mm in length, moving quickly across the scalp.
Nits: ivory-colored, oval structures cemented within 1 cm of the scalp; they appear darker when empty and lighter when filled with an embryo.
Itching: persistent scalp irritation caused by allergic reaction to lice saliva.
Redness or small sores: results of scratching or bite marks.

Confirm the presence of live lice by gently lifting a suspected egg and examining its attachment. A firmly attached nit will not slide easily; a loose one may fall off when the hair is brushed. If live insects are observed in multiple sections, the infestation is confirmed and treatment should commence promptly.

Next Steps for Treatment

After confirming the presence of lice, begin treatment immediately. Use a product that contains a proven insecticide, such as permethrin 1% or pyrethrin 0.5%, following the package instructions precisely. Apply the lotion or shampoo to dry hair, leave it on for the recommended time, then rinse thoroughly.

Remove live insects and nits with a fine‑tooth comb, working from scalp to tips. Comb sections systematically, cleaning the comb after each pass.
Repeat the chemical application after seven to ten days to eliminate newly hatched lice that survived the first cycle.
Wash clothing, bedding, and personal items used within the previous 48 hours in hot water (≥ 130 °F) and dry on high heat. Items that cannot be laundered should be sealed in a plastic bag for two weeks.
Vacuum carpets, upholstered furniture, and car seats to capture any stray lice or eggs.
Inspect all household members daily for at least two weeks. Treat anyone who shows signs of infestation with the same regimen.

If over‑the‑counter products fail, prescribe a stronger agent such as malathion 0.5% or ivermectin, administered under medical supervision. Persistent symptoms after two treatment cycles warrant a dermatologist’s evaluation to rule out resistance or secondary infection. Maintain the cleaning and inspection schedule throughout the entire period to prevent re‑infestation.