How to Check for Lice
Lice. The word alone makes parents squirm. But while they’re definitely something we all want to avoid, the good news is that lice aren’t a serious health threat—just an uncomfortable nuisance that you’ll want to get rid of as soon as possible. And to do that, knowing what those pesky little bugs look like and how to check for lice is key.
Lice are tiny bugs about the size of a sesame seed. “They have six tiny legs and little claws that help them grab the hair,” says Ruben Espinoza, MD, a pediatrician with Banner Medical Group in Mesa, Arizona. “Head lice can only crawl, they can’t jump or hop.” Lice love hanging out in hair because they feed off blood from the scalp. When full after a big meal, they develop a reddish-brown color.
Lice eggs—aka “nits”—are tiny and white, and often look like dandruff, but unlike dandruff, nits stick to the hair strands and aren’t as easy to remove. Once they hatch, the young lice, or “nymphs,” are clear in color and usually leave the empty egg casings behind in the hair.
“Lice are tricky—they don’t like to be found. They hide,” says Lauren Kupersmith, MD, a pediatrician at Hassenfeld Children’s Hospital at NYU Langone in New York City. And while they don’t fly, they can scurry for cover in the blink of an eye, making it harder to spot them. Luckily, there are a few tricks every parent should have up their sleeve for how to check for lice.
The best way to look for lice is by carefully combing your child’s hair, keeping an eye out for the eggs and bugs, Espinoza says. You can choose to separate the hair with your fingers or an everyday comb, but your better bet is to use a special lice comb, which has very thin teeth and can be found at most drugstores. Follow these step-by-step instructions for how to check for lice and how to get a thorough combing.
1. Detangle the hair using a wide-tooth comb. This makes it easier to use the lice comb and avoid painful tugging. For kids with longer hair, it may be helpful to divide the hair into separate sections and secure with a hair elastic; this way, you can inspect one section at a time.
2. Comb around the hairline. With the fine-tooth lice comb, start combing at the bottom of the neck and behind the ears, close to the hairline. “Lice are usually around the warmer spots,” Espinoza says. Comb from the root, right at the scalp, down to the end of the strand, and be sure your strokes overlap so you don’t miss a section of hair. The movement will likely cause the lice to move toward the top of the head, but keep a sharp lookout for nits.
3. Check the comb for lice. After each brushstroke, inspect the comb for bugs and nits—you can even wipe it on a white cloth to see if you’ve caught any. “Lice will stick to the comb if they’re there,” Espinoza says.
4. Repeat until the entire head has been checked. Work your way through your child’s hair, leaving the top and front of the hair last, since this is where you’ll have cornered any live lice that are on the run.
If you do spot live lice or eggs, Kupersmith recommends getting evaluated by a pediatrician. “By the time you notice bugs, it’s a pretty full-blown infestation,” she says. You’ll likely need to start an over-the-counter topical treatment, such as a lice-killing shampoo. Get the 411 on lice treatment and prevention here.
When you’re checking for lice, the key is combing thoroughly and taking your time. It also helps to keep these other tips in mind as you hunt down head lice:
• Check your child’s hair once a month. “If you do see something, you can catch it on the early side,” Kupersmith says. This is especially important if you get a notice from your child’s day care or school that a lice problem is going around.
• Check for lice on wet or dry hair. Either works, it just depends on your preference. Washing the hair first will help with detangling but will take a little more time.
• Conduct your lice check in a well-lit area. It’s hard enough to spot the tiny bugs, so seating your child under a bright light will help with your hunt.
• Don’t confuse dandruff and nits. Dandruff will flake away, while nits will stick to the hair or lice comb.
Published October 2017
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.