Losing the Louse: How to Manage this Common Infestation in Children

Vicky R. Bowden, DNSc, RN


Pediatr Nurs. 2012;38(5):253-254. 

In This Article

Symptoms and Diagnosis

The symptoms of lice infestation include intense itching (pruritus). Any body area, including the scalp, may show signs of the child's intense scratching, such as erythema, scaling, and excoriation of the skin. Small, red bumps on the scalp, neck, and shoulders that may become crusty and ooze may also be visible. Head lice infestation is commonly first suspected when children are observed scratching their heads vigorously. Listlessness or poor school performance may also be clues, indicating the child's high level of distraction. On inspection of the scalp, tiny white specks (whitish to sandy colored eggs [nits]) can be easily seen on the hair shafts in natural light and will be difficult to remove. Nits can easily be mistaken for dandruff, but the critical difference is that nits must be picked off to be removed. Nits fluoresce white under Wood's light. Adult lice may be visualized under a microscope or a magnifying glass. They range in color from light beige to black and have six claw-like appendages.