I thought it was just dandruff...

When I ask parents when they first noticed their child's head lice, it usually becomes clear that the signs of head lice were present long before the parents would like to admit.  They say things like, "Sure, my daughter's head was really itchy, but I thought it was just because of dandruff" or "My son's been taking swimming lessons and I thought his head was itchy from the chlorine".  Sometimes, these parents have had no experience with head lice or they never knew anyone who had it so the possibility of head lice doesn't even come to mind.  However, many parents  are just in denial about head lice because they don't want to have to deal with it.  Later they tell me, "I thought it might be head lice but I didn't do anything at first because I was too busy" or "I knew that her friend at school had recently had head lice but I didn't think it would happen to my child".

In my house we have a rule - if you scratch your head, you get a quick spot check.  It is even true for me - if I scratch my head, my youngest daughter says, "Mom, c'mere. Let me take a look."  And these spot checks, because they are not always reliable, are still done in conjunction with weekly wet combing checks. Of course, someone's head is really, really itchy, they get a wet combing check right away. (I should mention that routine combings will often prevent the itchiness of head lice. Most people are asymptomatic - they don't get an itch - until they've had head lice for quite a while.  Routine combings will often find the bugs before the itching starts.  It happened to me!)

If someone is itchy, investigate. If you find that you or your child do have a lot of dandruff, use a dandruff shampoo to remove the dandruff before doing a check for head lice. With head lice, you need time to be on your side and the sooner you find the little critters, the sooner you can get rid of them. 

You Know What Happens When You Assume...

Your head is itchy, but you've had your head checked and your buddy can't see anything. No bugs and no eggs. Do you have head lice? Maybe - I miss eggs sometimes and sometimes I've seen tons of eggs but no live lice when I know that bugs just have to be there.

However, lice is not like a viral infection that gets into your cells. They are insects. The lice and nits (eggs) are tiny but can be seen without a microscope once they are found. People usually don't even feel more itchy than usual when they have just a couple of bugs.

If someone has checked your head and sees nothing, but your head is itchy everywhere, don't just assume that you have head lice (though feel free to start taking precautions - keep long hair up, don't share brushes, etc). The cause could be from something else, like dry scalp, which gets even drier if you start to put lice treatments on it. Don't jump to conclusions - just keep an eye on your head until the itch settles down.

Imposters, Part 3 - Other Parasites

For all the press it gets, we often forget that pediculosis capitis (head lice) is pretty harmless. It's annoying. It's tiring. But, there are no real health risks directly related to this condition.

However, if you think you have head lice, answer some questions like these for yourself:

Do I have any itching/bites on ANY other parts of my body?

Do I feel ill or have any other symptoms (such as vomiting, diarrhea, muscle or joint aches, fatigue, flaky skin)?

If you are experiencing any other unusual symptoms besides the itchiness on your scalp, there may be something other than head lice going on. Especially if you haven't actually seen any bugs or eggs on your scalp. There are other illness, and other parasites, that can cause your scalp to be itchy. Some that can cause real health problems. If you call me, I will ask you questions. And while I can still come and check for head lice, I may recommend that you visit your family doctor.