How can lice in children be distinguished from dandruff? - briefly
Live insects or moving eggs clinging to hair shafts confirm head lice, while dandruff consists of dead skin flakes that can be brushed away. Lice produce intense, localized itching and visible nits near the scalp; dandruff yields powdery, white flakes that fall freely and lack any live organisms.
How can lice in children be distinguished from dandruff? - in detail
Head lice and dry scalp scales may appear similar, but several observable characteristics allow reliable distinction.
-
Size and shape: Live insects measure 2–4 mm, have a flattened, elongated body, and are visible as tiny, tan‑brown specks. Flakes are irregular, paper‑thin pieces ranging from 0.5 mm to several millimeters, lacking a defined body outline.
-
Mobility: Lice move actively when the hair is examined, especially when brushed or shaken. Scalp flakes remain stationary, even after gentle manipulation.
-
Attachment: Adult lice cling to hair shafts close to the scalp, often near the neckline, behind the ears, and at the crown. Nits (eggs) are glued firmly to the hair shaft, appearing as oval, yellow‑white or brownish shells that cannot be brushed away easily. Dandruff particles detach readily and fall to the shoulders or clothing.
-
Sensation: A child infested with lice typically reports itching that intensifies several hours after washing, due to an allergic reaction to the insect’s saliva. The itch from dry scalp is usually constant, worsens with dryness, and may be relieved by moisturizing shampoos.
-
Visual inspection under magnification: Using a fine‑tooth comb or a magnifying lens reveals live lice and nits attached to hair strands. Flakes appear as loose, translucent fragments without a cemented base.
-
Response to treatment: Pediculicidal shampoos or topical insecticides eliminate lice within a few days, after which the itching subsides. Anti‑dandruff shampoos containing zinc pyrithione or selenium sulfide reduce flaking but have no effect on live insects.
Diagnostic procedure:
- Separate a small section of hair from the scalp.
- Part the hair finely and examine the base with a magnifying device.
- Look for moving insects, egg shells affixed to the shaft, or solely detached white flakes.
- If only flakes are present, consider a dry‑scalp regimen; if lice or nits are found, initiate a pediculicide protocol and repeat combing after 7–10 days to catch newly hatched lice.
These criteria provide a systematic approach for clinicians, parents, or caregivers to accurately identify whether a child’s scalp condition is caused by ectoparasites or by sebaceous shedding.