Symptoms

Common signs and symptoms of a lice infestation can include:

• Itching. The most common symptom of a lice infestation is itching on the scalp, neck and ears. This is an allergic reaction to louse bites. When a person has a lice infestation for the first time, itching may not occur for four to six weeks after infestation.
• Lice on scalp. Lice may be visible but are difficult to spot because they're small, avoid light and move quickly.
• Lice eggs (nits) on hair shafts. Nits stick to hair shafts. Incubating nits may be difficult to see because they're very tiny. They're easiest to spot around the ears and the hairline of the neck. Empty nits may be easier to spot because they're lighter in color and further from the scalp. However, the presence of nits doesn't necessarily indicate an active infestation.
• Sores on the scalp, neck and shoulders. Scratching can lead to small, red bumps that may sometimes get infected with bacteria.

When to see a doctor

See your doctor before you begin treatment if you suspect that you or your child has a head-lice infestation. Studies show that many children have been treated for head lice with over-the-counter medications or home remedies when they don't have an active head-lice infestation.

Things often mistaken for nits include:

• Dandruff
• Residue from hair products
• Bead of dead hair tissue on a hair shaft (hair cast)
• Scabs, dirt or other debris
• Other small insects found in the hair