What do lice look like on a child's hair?

Understanding Head Lice

What are Head Lice?

The Lifecycle of a Louse

Lice infestations in children are visible because the insects cling to hair shafts and move across the scalp. Understanding the insect’s development clarifies why early detection matters.

The life cycle consists of three distinct stages:

Egg (nit) – Oval, about 0.8 mm long, attached to a single hair strand near the scalp. Eggs hatch after 7–10 days at body temperature.
Nymph – Immature louse resembling an adult but smaller and lacking fully developed reproductive organs. Nymphs undergo three molts over 9–12 days, each molt marked by a brief period of inactivity.
Adult – Fully formed, 2–3 mm long, grayish‑brown, with six legs adapted for grasping hair. Adults live 30 days on a host, feed several times daily, and each female can lay 6–10 eggs per day.

A single adult female can produce up to 100 eggs during her lifespan, creating a rapid population increase if the infestation is not treated. Eggs remain firmly glued to hair until they hatch; removal requires combing or chemical agents that dissolve the cement. Nymphs and adults survive only on human blood and cannot live more than two days off the host. Breaking the cycle—by eliminating eggs, killing nymphs, and preventing adult reproduction—stops the spread of lice on a child's scalp.

How Lice Spread

Lice move from one child to another primarily through direct head-to-head contact. The insects cling to hair shafts with strong claws, allowing them to transfer instantly when two heads touch during play, sports, or classroom activities.

Other transmission routes include:

Sharing personal items such as combs, brushes, hats, helmets, or hair accessories that have recently contacted an infested scalp.
Contact with contaminated fabrics—pillows, blankets, or upholstered furniture—where lice or their eggs have fallen.
Use of infested clothing, especially jackets or scarves, that have been in close proximity to a head.

Lice cannot jump or fly; they rely on crawling. Even brief contact lasting a few seconds can be sufficient for an adult female or nymph to relocate. Crowded environments, inadequate laundering of shared textiles, and neglecting regular hair inspections increase the likelihood of spread.

Common Misconceptions about Lice

Lice vs. Dandruff

Lice are live insects about the size of a sesame seed, with a gray‑brown, elongated body and six legs that grasp individual hair strands. Their bodies are visible as tiny, moving specks close to the scalp, often near the nape of the neck or behind the ears. Eggs (nits) appear as oval, white or yellowish shells firmly attached to the hair shaft, usually within a millimeter of the scalp, and they do not slide down the hair.

Dandruff consists of dry, flaky skin particles that detach from the scalp. Flakes are white or light gray, vary in size from fine powder to larger pieces, and drift freely on the shoulders or clothing. Dandruff does not cling to hair shafts, and no live organisms or eggs are present.

Key visual differences:

Mobility: Lice move actively; dandruff remains stationary.
Attachment: Nits are glued to hair close to the scalp; dandruff flakes are loosely attached and fall off easily.
Color and texture: Lice have a solid, slightly translucent body; dandruff appears as dry, powdery scales.
Location: Lice concentrate behind ears, at the hairline, and on the neck; dandruff is distributed across the scalp and can fall onto shoulders.

Recognizing these characteristics allows accurate identification and appropriate treatment for an infestation versus a simple scalp condition.

Lice vs. Other Scalp Conditions

Lice are tiny, wing‑less insects measuring 2–3 mm in length. Their bodies are gray‑brown, flattened, and segmented, allowing them to cling tightly to each hair shaft. Live lice move actively, crawling up and down strands, and can be seen moving when the scalp is examined closely. Nits—lice eggs—appear as oval, white or yellowish shells attached firmly to the hair shaft within a quarter‑inch of the scalp; they do not detach easily and are often mistaken for dandruff.

Other scalp conditions present distinct visual cues:

Dandruff: white, flaky particles that easily brush off; no live insects or attached eggs.
Seborrheic dermatitis: greasy, yellowish scales with reddened skin; inflammation may cause itching but no crawling organisms.
Tinea capitis (ringworm): circular patches of hair loss with scaling and sometimes black dots where hairs have broken; fungal spores are microscopic, not visible to the naked eye.
Folliculitis: small red pustules or papules around hair follicles; may contain pus but no mobile insects.
Scalp psoriasis: thick, silvery plaques that adhere firmly to the skin; no movement or egg structures.

When inspecting a child’s hair, the presence of live, mobile insects and firmly attached, oval nits distinguishes lice from these conditions. A thorough visual examination, preferably under bright light and using a fine-tooth comb, confirms the diagnosis. Treatment decisions should be based on this clear differentiation.

Identifying Lice on a Child's Hair

What to Look For: Live Lice

Size and Color

Lice that infest a child’s scalp are tiny insects typically measuring between 2 mm and 3 mm in length when fully grown. Their bodies are flattened laterally, allowing them to cling tightly to hair shafts. Nymphs, the immature stages, are roughly half the size of adults, ranging from 0.8 mm to 1.5 mm, and become visible only after several days of development.

Coloration varies with feeding status and age. Adult lice usually appear gray‑white to light brown; after ingesting blood, their abdomen may take on a reddish or darker hue. Nymphs are generally paler, often a translucent or milky shade, becoming more pigmented as they mature. The overall appearance is a uniform, non‑shiny coloration that blends with the hair, making detection reliant on close visual inspection.

Preferred Locations on the Scalp

Lice infest a child’s hair by attaching to the scalp where temperature and humidity are optimal. They concentrate in areas that protect their bodies from detection and provide easy access to blood meals.

The region behind each ear, where hair is dense and the skin is less exposed.
The lower occipital area (the nape of the neck), a warm pocket shielded by hair.
The crown, especially the junction between the top of the head and the sides, where hair strands converge.
The area above the forehead, near the hairline, where hair density is high.
The sides of the head, close to the temples, where hair forms a natural cradle.

Nits are most often found within a half‑inch of the scalp on the shaft of a hair, primarily in the same zones listed above. The concentration of lice and their eggs in these locations facilitates rapid reproduction and makes detection and removal more challenging.

Movement and Behavior

Lice on a child’s scalp are small, wingless insects that navigate hair shafts by gripping each strand with their six legs. Their legs end in claw‑like hooks, allowing rapid, deliberate crawling forward or backward. Movement is typically slow, covering only a few centimeters per minute, but the insects can change direction instantly when encountering obstacles or when the host shifts position.

Feeding behavior centers on blood extraction. After locating a suitable spot near the scalp, a louse pierces the skin with its mouthparts, creates a small wound, and draws blood for several minutes before retreating. This feeding cycle repeats several times a day, prompting the insect to move to new locations to avoid host detection.

Reproductive activity influences movement patterns as well. Adult females lay eggs (nits) near the hair base, securing them with a cement‑like substance. Once an egg is deposited, the female often moves away to find another site, resulting in a scattered distribution of nits along the hair shaft. The following points summarize key aspects of louse behavior:

Crawling: deliberate, hook‑driven, limited speed, capable of quick direction changes.
Feeding: intermittent blood‑sucking bouts lasting 5–10 minutes, followed by relocation.
Egg‑laying: placement of nits close to the scalp, each cemented to a single hair strand; females disperse after each oviposition.
Host response: movement increases when the child brushes hair, vibrates the scalp, or changes temperature.
Survival strategy: avoidance of crowded areas, preference for sheltered regions behind the ears and at the nape.

What to Look For: Nits (Lice Eggs)

Appearance and Attachment

Lice that infest a child's scalp are tiny, wing‑less insects measuring 2–4 mm in length. Their bodies are elongated and flattened, with a creamy‑white or light brown coloration that may appear translucent when the insects are engorged with blood. The head is broader than the thorax, and six legs end in sharp claws adapted for gripping hair shafts.

The parasites remain attached to the hair by:

Claw‑type legs that grasp the hair shaft close to the scalp.
A ventral hook that secures the body against the hair.
Female lice cementing eggs (nits) to the hair shaft about 1 mm from the scalp; the cement is a proteinaceous substance that hardens quickly and resists removal.

Live lice move rapidly through the hair, often traveling up and down the shaft while maintaining contact with the scalp for blood meals. Nits appear as tiny, oval, yellow‑white ovals firmly affixed to the hair, and they are most visible near the base of the hair strand.

Differentiating Nits from Hair Casts

Lice eggs (nits) and hair casts are often confused because both appear as small, whitish objects attached to hair shafts. Nits are the actual ova of head‑lice; they are cemented to the hair close to the scalp, usually within ¼‑½ inch from the skin. The cement is a sticky, opaque substance that makes the nit difficult to slide along the hair. Nits are oval, about 0.8 mm long, and have a characteristic operculum (a tiny cap) at one end. They do not move and remain fixed until the larva hatches.

Hair casts, also called pseudonits, are cylindrical, white or translucent sleeves that encircle the hair shaft. They are composed of keratin debris and are loosely attached; a gentle pull will cause them to slide down the hair. Casts are longer than nits, often 2‑5 mm, and have a tubular shape without an operculum. They can be found at any distance from the scalp and are not a sign of infestation.

Key visual differences:

Attachment: Nits are firmly glued near the scalp; casts loosen and slide when the hair is brushed.
Shape: Nits are oval with a visible cap; casts are tube‑shaped, smooth, and lack a cap.
Size: Nits ≈ 0.8 mm; casts range from 2 mm to 5 mm.
Location: Nits cluster close to the scalp; casts may appear farther down the shaft.
Movement: Nits remain stationary; casts can be moved along the hair with gentle pressure.

Viable vs. Empty Nits

Lice on a child's hair appear as tiny, winged insects about the size of a sesame seed. Their bodies are gray‑brown, flattened, and they move quickly through the strands. The eggs they lay, called nits, attach firmly to the hair shaft near the scalp.

Viable nit: translucent or slightly yellow, oval, about 0.8 mm long, with a visible white or pale gray embryo inside; the shell is intact, and the nit remains stuck to the hair even after gentle tugging.
Empty nit: opaque, brownish, often cracked or collapsed; the interior is empty, and the shell may loosen or fall off when lightly pulled.

Identifying a viable nit requires close inspection with a fine‑tooth comb or magnifier. Look for the characteristic curved shape and the faint shine of the developing louse inside. Empty nits lack this shine and often appear dry and brittle. Removing both types reduces the chance of reinfestation, but targeting viable nits eliminates the immediate threat of hatching.

Common Symptoms of a Lice Infestation

Itching and Irritation

Lice infestations on a child’s scalp trigger a distinct pattern of itching and irritation. The bite of a female head louse injects saliva that contains anticoagulant compounds, provoking a localized inflammatory response. This reaction manifests as a persistent, often worsening urge to scratch, especially after periods of inactivity such as bedtime or school lessons.

Typical signs of irritation include:

Red, raised papules concentrated near the hairline, behind the ears, and at the nape of the neck.
Small, punctate lesions that may become crusted if the child scratches excessively.
Swelling of the scalp skin, occasionally accompanied by a mild warmth to the touch.

The intensity of itching correlates with the number of active lice and the duration of the infestation. Early stages may produce only occasional discomfort, while heavy infestations generate continuous scratching that can lead to secondary bacterial infection. Prompt identification of these symptoms, combined with visual inspection for live insects or nits, is essential for effective treatment and prevention of further skin damage.

Scratch Marks and Sores

Lice infestations on a child’s scalp often produce visible evidence beyond the insects themselves. The most common secondary signs are scratch marks and sores, which result from the child’s attempts to relieve itching caused by bites.

Scratch marks appear as linear or irregular abrasions along the hairline, behind the ears, and on the nape of the neck. They are typically shallow, with fresh scratches showing pink or reddish coloration, while older lesions may develop a darker hue as they heal. Repeated scratching can merge adjacent marks, forming larger areas of irritated skin.

Sores develop when scratching damages the epidermis, creating open wounds that may bleed or ooze. These lesions are prone to secondary bacterial infection, especially if the child continues to scratch. Infected sores often present with increased redness, swelling, warmth, and a yellowish or purulent discharge.

Key points for identification:

Linear or irregular abrasions near the hairline, ears, and neck.
Fresh scratches: pink to red; older scratches: darker, possibly scabbed.
Open wounds with possible exudate.
Signs of infection: heightened redness, swelling, warmth, discharge.

Prompt treatment of the infestation, combined with careful wound care, reduces the risk of complications and promotes faster healing of the skin. Clean the affected areas with mild antiseptic solutions, keep fingernails trimmed, and discourage the child from scratching to prevent further tissue damage.

Difficulty Sleeping

Lice infestations disrupt a child’s sleep by creating constant scalp irritation. Adult lice are about the size of a sesame seed, gray‑brown, and move quickly through hair. Nymphs are smaller, translucent at first, then darken after feeding. Eggs, or nits, cling tightly to hair shafts near the scalp and appear as tiny, oval, yellow‑white specks. The itching caused by bites intensifies at night when the child lies still, leading to frequent awakenings, restlessness, and difficulty falling asleep.

Key factors that translate the presence of lice into sleep problems:

Persistent pruritus that awakens the child multiple times.
Anxiety about visible insects, causing mental agitation before bedtime.
Parental attempts to soothe itching with scratching, which can damage scalp skin and increase discomfort.
Disruption of routine bedtime rituals due to urgent need for treatment.

Effective management reduces sleep disturbance. Prompt removal of live insects and nits, followed by a suitable pediculicide, eliminates the source of irritation. Regular combing with a fine‑toothed lice comb removes residual eggs, decreasing the chance of re‑infestation. Maintaining clean bedding and clothing prevents re‑exposure. After treatment, the child’s scalp calms, allowing uninterrupted sleep and restoration of normal rest patterns.

Practical Steps for Detection

Preparing for a Lice Check

Necessary Tools

When examining a child’s hair for the presence of head‑lice, a reliable set of instruments is essential. Each item serves a specific function that reduces misidentification and speeds up treatment decisions.

Fine‑toothed lice comb (spacing 0.2–0.3 mm) – separates strands, captures live insects and eggs.
Handheld magnifying glass or loupes (10×–15×) – enlarges nits and adult lice for clear visualization.
Bright, focused LED flashlight – illuminates the scalp, revealing translucent nits attached near the hair shaft.
Disposable nitrile gloves – protect the examiner from potential contamination.
Lice detection kit (includes comb, magnifier, and reference images) – provides standardized reference for accurate assessment.
Small sterile container with lid – stores captured specimens for laboratory confirmation if needed.
Disinfectant wipes or alcohol solution – cleans comb and surfaces after each examination.
Sealable plastic bag – disposes of collected lice and nits safely.

Using these tools in combination ensures thorough inspection, minimizes false negatives, and supports prompt, effective intervention.

Optimal Lighting

Optimal lighting enhances the visibility of head‑lice and their nits in a child’s hair. Direct, diffused daylight provides the highest contrast; sunlight filtered through a thin curtain removes harsh shadows while preserving color fidelity. When natural light is unavailable, a high‑intensity white LED source (5000–6500 K) positioned 30–45 cm from the scalp yields comparable results. The light should illuminate the scalp at a 45‑degree angle to reduce glare on glossy hair strands and to expose the translucent bodies of lice.

Key lighting parameters:

Intensity: 1500–2000 lux measured at the hair surface.
Color temperature: 5000–6500 K for neutral white light.
Beam spread: Wide, uniform distribution to avoid hot spots.
Angle: 30–60 degrees relative to the scalp plane.
Polarization: Optional linear polarizer can diminish specular reflections.

Supplementary magnification (2.5–5× handheld loupe) combined with the described lighting conditions reveals the oval, gray‑white bodies of adult lice and the oval, brownish nits attached to hair shafts. Consistent application of these lighting guidelines enables rapid identification and accurate assessment.

The Step-by-Step Inspection Process

Sectioning the Hair

Sectioning the hair creates a clear view of each scalp area, allowing precise identification of lice and their eggs. By separating strands into manageable sections, the examiner can expose the base of the hair where nits attach and spot adult insects that blend with the scalp’s color and texture.

Effective sectioning follows a systematic pattern:

Part the hair from the crown to the nape, creating a vertical line.
Divide the area into four quadrants: left‑front, right‑front, left‑back, right‑back.
Within each quadrant, create horizontal rows spaced 1‑2 cm apart.
Secure each row with a fine‑tooth comb or a small clip to keep it flat while inspecting.
Examine the exposed scalp under adequate lighting, looking for the oval, tan‑brown bodies of lice and the smaller, pear‑shaped nits attached to the hair shaft.

Consistent use of this method reduces missed detections, ensures thorough coverage of the scalp, and facilitates prompt treatment decisions.

Thorough Examination Technique

A thorough head‑inspection begins with a well‑lit, clean area and a fine‑toothed comb. The examiner should separate the hair into sections, starting at the scalp and working outward. Each section is combed slowly, allowing the teeth to capture any organisms or eggs lodged close to the skin.

Key visual cues include:

Live insects: tan‑brown, flattened bodies about 2–4 mm long, with six legs. The abdomen may appear slightly translucent, revealing internal contents. Movement is rapid when disturbed.
Nits: oval, white or yellowish capsules firmly attached to the hair shaft within ¼ inch of the scalp. The shell is smooth, and the interior may show a developing nymph as a darker spot.
Shells (empty nits): translucent, empty casings that remain affixed to hair but lack internal material.

The technique requires repeated passes—three to five times per section—to reduce false negatives. After combing, the examiner places the comb teeth onto a white surface (paper towel or tray) and inspects under magnification (10×–20×). Any captured specimens are recorded, and the presence of live lice or viable nits confirms infestation.

Cleaning the comb with alcohol between sections prevents cross‑contamination. Documentation should note the location of findings (e.g., crown, occipital region) and the density of organisms per section. This systematic approach maximizes detection accuracy while minimizing discomfort for the child.

What to Do If You Find Lice

Lice appear as tiny, tan‑gray insects clinging to hair shafts, often near the scalp, and may be accompanied by white nits attached to strands. When you discover them, immediate, systematic action prevents spread and reduces discomfort.

Separate the child’s clothing, bedding, and personal items from others; place them in sealed plastic bags for at least 48 hours.
Apply a lice‑specific treatment approved for children, following the manufacturer’s dosage and timing instructions precisely.
Use a fine‑toothed comb on wet, conditioned hair to remove live insects and nits; comb from scalp outward, cleaning the comb after each pass.
Repeat the treatment and combing process after 7–10 days to eliminate any newly hatched lice that survived the first application.
Vacuum carpets, upholstered furniture, and car seats; discard or wash in hot water (≥130 °F) any towels, hats, or hair accessories used within the past two weeks.
Notify the child’s school or daycare so they can implement appropriate screening and inform other families.

Monitor the scalp for a week after the second treatment; if live lice persist, consult a healthcare professional for alternative therapy. Maintaining regular checks and prompt removal eliminates infestations efficiently.