Head Lice: Diagnosis and Therapy

Gabriel J. Martinez-Diaz, MD; Anthony J. Mancini, MD


Dermatology Nursing 

In This Article

Clinical Manifestations

Children with head lice may initially be asymptomatic. However, itching, which is confined to the scalp, and which may become quite severe in intensity, is common and is traditionally the first clinical symptom. Nits are attached by the louse to hair shafts, within a few millimeters from the scalp, and can often be found in the occipital and posterior auricular regions of the head. It is often easier to observe nits (which appear as oval-shaped, white-to-tan-to-gray eggs firmly attached to the hair shaft) than adult crawling lice. Other possible manifestations of a head lice infestation include excoriations, secondary impetiginization, pyoderma with or without hair loss, cervical lymphadenopathy, conjunctivitis, fever, malaise, and occasionally a diffuse morbilliform hypersensitivity eruption (AAP, 2009; Janniger & Kuflik, 1993; Mumcuoglu, Klaus, Kafka, Teiler, & Miller, 1991).


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: