How can I differentiate lice from dandruff on a child's head? - briefly
Live lice appear as small, tan or gray insects that move on the scalp and lay eggs (nits) firmly attached to hair shafts near the skin; dandruff consists of loose, white or yellowish flakes that detach easily and show no movement. Inspect the hair with a fine‑tooth comb on a damp head: the presence of moving insects or attached nits confirms lice, while only flakes indicate dandruff.
How can I differentiate lice from dandruff on a child's head? - in detail
Lice and dandruff can appear similar to the untrained eye, but several observable characteristics allow reliable distinction.
- Size and shape: Live insects are about 2–3 mm long, oval, and have six legs. Dandruff flakes are irregular, flat, and range from a few millimeters to a centimeter in diameter.
- Movement: Lice crawl actively across hair shafts and may be seen shifting when the scalp is examined. Dandruff remains stationary.
- Attachment: Lice cling to hair close to the scalp, especially behind the ears, at the neckline, and near the crown. Dandruff accumulates on the surface of the scalp and can be brushed off easily.
- Color and texture: Live nits (eggs) are oval, tan or gray, firmly attached to the hair shaft, and do not detach with gentle pulling. Dandruff flakes are white or yellowish, powdery, and lift off with a comb or fingers.
- Itching pattern: Lice bites produce localized, intense itching, often worsening several hours after contact. Dandruff‑related irritation is generally milder and constant.
Inspection routine
- Part the hair in sections, starting at the crown and moving outward.
- Use a fine‑toothed lice comb on wet hair; slide the comb slowly to capture any moving insects or attached nits.
- Examine the comb and hair shafts under good lighting. Live lice appear as small grayish‑brown bodies; nits look like tiny, immobile ovals attached close to the scalp.
- If only white flakes are observed and they detach easily, the condition is likely seborrheic dermatitis (dandruff).
Management guidance
- When live insects or attached eggs are confirmed, treat with a pediculicide approved for children, following the product’s dosage and repeat‑treatment schedule precisely.
- For persistent flakes, use an anti‑dandruff shampoo containing zinc pyrithione, selenium sulfide, or ketoconazole, applying to the scalp for the recommended duration before rinsing.
- Clean bedding, clothing, and personal items by washing at 60 °C or sealing in plastic bags for two weeks to eliminate any residual parasites.
When professional evaluation is required
- Presence of numerous live insects despite treatment.
- Severe itching, secondary skin infection, or allergic reaction.
- Uncertainty after self‑inspection.
Accurate visual assessment combined with systematic combing provides the most effective method for distinguishing between head‑lice infestation and ordinary dandruff on a child’s scalp.