What are head lice?
The head louse, or Pediculus humanus capitis (peh-DICK-you-lus HUE-man-us CAP-ih-TUS), is a parasitic insect that can be found on the head, eyebrows, and eyelashes of people. Head lice feed on human blood several time a day and live close to the human scalp. Head lice are not known to spread disease.
Who is at risk for getting head lice?
Head lice are found worldwide. In the United States, infestation with head lice is most common among preschool children attending child care, elementary school children, and the household members of infested children. Although reliable data on how many people in the United States get head lice each year are not available, an estimated 6 million to 12 million infestations occur each year in the United States among children 3 to 11 years of age. In the United States, infestation with head lice is much less common among African-Americans than among persons of other races, possibly because the claws of the of the head louse found most frequently in the United States are better adapted for grasping the shape and width of the hair shaft of other races.
Head lice move by crawling; they cannot hop or fly. Head lice are spread by direct contact with the hair of an infested person. Anyone who comes in head-to-head contact with someone who already has head lice is at greatest risk. Spread by contact with clothing (such as hats, scarves, coats) or other personal items (such as combs, brushes, or towels) used by an infested person is uncommon. Personal hygiene or cleanliness in the home or school has nothing to do with getting head lice.
What do head lice look like?
Head lice have three forms: the egg (also called a nit), the nymph, and the adult.
Egg/Nit: Nits are lice eggs laid by the adult female head louse at the base of the hair shaft nearest the scalp. Nits are firmly attached to the hair shaft and are oval-shaped and very small (about the size of a knot in thread) and hard to see. Nits often appear yellow or white although live nits sometimes appear to be the same color as the hair of the infested person. Nits are often confused with dandruff, scabs, or hair spray droplets. Head lice nits usually take about 8-9 days to hatch. Eggs that are likely to hatch are usually located no more than 1/4 inch (or 1 centimeter) from the base of the hair shaft.
Nymph: A nymph is an immature louse that hatches from the nit. A nymph looks like an adult head louse, but is smaller. To live, a nymph must feed on blood. Nymphs mature into adults about 9-12 days after hatching from the nit.
Adult: The fully grown and developed adult louse is about the size of a sesame seed, has six legs, and is tan to grayish-white in color. Adult head lice may look darker in persons with dark hair than in persons with light hair. To survive, adult head lice must feed on blood. An adult head louse can live about 30 days on a person's head but will die within one or two days if it falls off a person. Adult female head lice are usually larger than males and can lay about six eggs each day.
Where are head lice most commonly found?
Head lice and head lice nits are found almost exclusively on the scalp, particularly around and behind the ears and near the neckline at the back of the head. Head lice or head lice nits sometimes are found on the eyelashes or eyebrows but this is uncommon. Head lice hold tightly to hair with hook-like claws at the end of each of their six legs; head lice nits are cemented firmly to the hair shaft and can be difficult to remove.
What are the signs and symptoms of head lice infestation?
- Tickling feeling of something moving in the hair.
- Itching, caused by an allergic reaction to the bites of the head louse.
- Irritability and difficulty sleeping; head lice are most active in the dark..
- Sores on the head caused by scratching. These sores can sometimes become infected with bacteria found on the person's skin.
How did my child get head lice?
Head-to-head contact with an already infested person is the most common way to get head lice. Head-to-head contact is common during play at school, at home, and elsewhere (sports activities, playground, slumber parties, camp).
Uncommonly, head lice may be spread by sharing clothing or belongings onto which lice or nits may have crawled or fallen. Examples include:
- sharing clothing (hats, scarves, coats, sports uniforms) or articles (hair ribbons, barrettes, combs, brushes, towels, stuffed animals) recently worn or used by an infested person;
- or lying on a bed, couch, pillow, or carpet that has recently been in contact with an infested person. The risk of getting an infestation by a louse or nit that has fallen onto a carpet or furniture is very small.
Dogs, cats, and other pets do not play a role in the spread of human lice.
How is head lice infestation diagnosed?
The diagnosis of a head lice infestation is best made by finding a live nymph or adult louse on the scalp or hair of a person. Because nymphs and adult lice are very small, move quickly, and avoid light, they can be difficult to find. Use of a magnifying lens and a fine-toothed comb may be helpful to find live lice. If crawling lice are not seen, finding nits firmly attached within a 1/4 inch of base of the hair shafts strongly suggests, but does not confirm, that a person is infested and should be treated. Nits that are attached more than 1/4 inch from the base of the hair shaft are almost always dead or already hatched. Nits are often confused with other things found in the hair such as dandruff, hair spray droplets, and dirt particles. If no live nymphs or adult lice are seen, and the only nits found are more than 1/4-inch from the scalp, the infestation is probably old and no longer active and does not need to be treated.
If you are not sure if a person has head lice, the diagnosis should be made by their health care provider, local health department, or other person trained to identify live head lice.
Image of the life cycle of the louse from the DPDx pages of the CDC