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Lice vs. Dandruff

Dandruff and head lice (Pediculus Humanus Capitis) are two common conditions that affect the hair and scalp.

Sometimes when you are looking for head lice it can be mistaken for dandruff, the nits (empty eggshells) look very similar to dandruff.

So how can you tell the difference between a head lice infestation and dandruff?

Here is how to tell the difference between head lice and dandruff

Head lice are parasitic insects that feed on human blood from the scalp. Head lice come in three forms, Lice Eggs (nits ), Nymph(baby lice) and adult lice. There are known to be 6-12 million cases of head lice a year in the United States alone! This is according to the centers for disease control.

Anyone can be infested but it is more common amongst children who come into the close head to head contact with each other.

Dandruff is a skin condition, non-inflammatory, resulting in excessively dry skin on the scalp. Dandruff affects around 50% of the world’s population, and can start during puberty, it is rare in people over the age of 50.

What are the different signs and symptoms of head lice vs. dandruff?

A head lice infestation and dandruff can both cause an itchy scalp, both are extremely common.

However, there are different symptoms that can help you decide on head lice and dandruff.

Lice infestation symptoms

  • Spotting head lice, lice eggs and nits close to the ears, by the temples and the back of the neck. These are the areas head lice symptoms occur.
  • You might notice movement from the head lice like a crawling sensation on the skin.
  • There can be bites and sores caused by an allergic reaction to the saliva of head lice.
  • A lot of scratching can lead to crusty sores, this happens when bacteria gets into the wound.
  • Swollen lymph glands on the front and back of the neck, along with a fever can indicate an infection from bacteria.
  • A lot of severe itching can cause sleepless nights.
  • People may feel irritable, caused by itching and a lack of sleep.

The stigma attached to head lice can make people feel anxious and worried.

There may be louse droppings on the pillowcases, they look like a speck of peppery dust.

Dandruff symptoms

Dandruff is a chronic skin condition the symptoms can be:

  • Flaky scalp skin can be very oily skin or very dry skin.
  • Itchy scalp.
  • White flakes or yellowish flakes on clothing.
  • Red areas on the scalp.
  • The symptoms can get worse with stress, drier weather or colder temperatures.

What are the causes of adult lice and dandruff?

The causes of these two conditions are completely different. The two conditions have nothing to do with a lack of personal hygiene.

Head lice are highly contagious parasites that can spread from one person to another through direct contact, they can also be picked up from personal items such as hair brushes, as they can live for a short time away from a host.

Dandruff is a chronic condition, but it is not contagious so you cannot catch dandruff, unlike nits and head lice. Studies are still being made on the causes of dandruff.

Some of the causes of dandruff can be:

Dandruff can be caused by, fungal infections, and yeast infections, or skin conditions like seborrheic dermatitis.

Seborrheic dermatitis affects areas with a lot of sebaceous glands like the scalp, ears, eyebrows and chest. Seborrheic dermatitis causes the skin to be scaley and red in appearance. Cradle cap is a form of dandruff found on some babies and very young children. Cradle cap can be treated, consult a doctor for advice.

Ringworm can make dandruff worse, it leaves red or silver marks on the skin and in some cases hair loss. Ringworm is also known as Tinea Capitis and is a fungal infection.

Malassezia yeasts are a fungus that causes the scalp to shed a lot of dandruff flakes.

Dandruff can be hereditary and therefore, can be passed down the generations.

How can you diagnose head lice and dandruff?

Just relying on itching alone is not a strong basis to diagnose head lice or dandruff. Some people have no itching at all.

The best method to diagnose head lice or dandruff is an entire scalp examination, you could use a magnifying glass as head lice are about the size of a sesame seed so extremely small, and nits are even smaller.

Head lice have six legs that have claws they can be brown to grayish-white, they do not have wings they crawl to get around in the hair and off the hair. The nymphs are tiny and brown and become an adult after a week of hatching.

The tell tale signs of head lice are finding live lice the size of a sesame seed and lice eggs and nits, even smaller, attached to the hair shafts, which is where the female lice lay eggs.

Do not use any over the counter treatments until live lice are found.

Dandruff flakes and nits appear similar which can lead to the wrong diagnosis and a non-effective treatment being used.

The way to decide if there are nits or dandruff is to try to remove them, dandruff will come away from the dry scalp easily, whereas nits are glued to the hair shafts and will not budge.

If you are still unsure you can see a doctor who will provide medical advice.

Treatments for dandruff and head lice

This is where the correct diagnosis is so important, the treatment for these two conditions are very different.

Do not worry if you have found live lice on your child’s head or other family members heads, it can be effectively treated!

You can try one of the following treatments:

Head lice will not just die if left untreated, the sooner you treat the hair the better.

Head lice treatments

Non-insecticide treatments are available to buy over the counter or online. With this lice treatment, the head lice and nits tend to be suffocated or dehydrated. Click here for more info.

In insecticide treatments, the chemicals will kill the head lice and the eggs.

A prescription shampoo can be obtained from a doctor. After treatment comb dead and live lice from the hair, a doctor may give a stronger prescription medication treatment if the problem continues, it may contain benzyl alcohol.

Depending on the medication a follow-up treatment after the first treatment may be needed if lice are still present.

Wet comb with a fine-tooth comb or nit comb. This lice treatment involves a lot of patience and must be done carefully to ensure nits and head lice are all removed from the hair shaft and scalp.

After the treatment of the hair wash clothes, towels and bedding in hot water, and dry on high heat, this will kill lice.

If children have stuffed animals etc place them in a bag and keep them sealed for at least 1 week to kill off the lice.

Dandruff treatments

If there are no live lice but a lot of dry flaky skin then it could be dandruff.

There are various types of anti-dandruff shampoo available in-store or online, check they contain Zinc Pyrithione, Salicylic acid, or Selenium sulphide. These dandruff shampoos are a medicated shampoo that will lower yeast levels on the scalp, which will reduce itchiness,

If these do not work it could be down to a higher level of yeast infection, or eczema on the scalp, see your doctor if this is the case.

In severe cases, you can ask your doctor for a topical steroid medication that will help to reduce any inflammation.

You can also try coal tar products, which are good for treating dandruff.

Neem oil and eucalyptus oil which has antifungal properties are both good for a dry scalp.

As a reminder at a glance

  • Location: The difference between lice and dandruff is that dandruff can be anywhere on the scalp, lice and nits are found near the nape of the neck and behind the ears where it is nice and warm for them.
  • Appearance: Nits are found attached to the hair shaft close to the scalp and cannot be easily removed, dandruff on the other hand will easily be removed from the hair.
  • Who is affected?: The difference between lice and dandruff is that lice affect school children and dandruff can start in the teenage years.
  • Are they both contagious?: A head lice infestation is highly contagious and the parasitic insects are caught through close contact with hair. You cannot be given dandruff from someone else.

And finally,

Please remember both of the conditions have stigmas attached to them, however, neither can be dangerous to anyone else and are treatable.

We hope this article has been helpful, if you have any questions please do not hesitate to drop us an email, we do our best to respond as quickly as possible.

Why not take a look at the rest of our website, we give advice and tips on numerous pests.

Good luck!

Ronald has 25 years of pest control experience under his belt. He scrutinizes each pest control method, product and process. 

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