Head Lice vs. Dandruff

  • Medical Author:
    John Mersch, MD, FAAP

    Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

There are a variety of treatments for dandruff.

Dandruff Treatment

Treatment of seborrhea (dandruff) is directed at fighting the skin inflammation. This is done either directly, by using cortisone-based creams and lotions (which reduce inflammation), or by using topical anti-yeast lotions and shampoos. Treatment should be directed at the cause of the dandruff.

Lice vs. dandruff facts

  • Lice infestations and dandruff, including infant/toddler seborrheic dermatitis (cradle cap), are extremely common.
  • Scalp/hair infestations by lice are due to a parasite. Dandruff is due to excessively inflamed, dry, or greasy scalp changes.
  • Common signs and symptoms for both lice and dandruff are itching and white structures on the scalp/hair shaft from either lice, nits, or dandruff (dried skin flakes).
  • Diagnosis is straightforward and effective therapy exists.

What are lice?

Lice are small parasites that can affect three areas of the human body. Head lice (the subject of this article), body lice, and pubic lice (also known as crabs) are causes by three different but related parasites. Lice infestation occurs only in humans. Head lice infestation is by far and away the most common version of the three parasitic infections and is very contagious. Direct contact or sharing of items (fomites) that would touch the infected individual's hair/scalp is the primary mode of transmission from one person to another. Examples would include sharing caps, combs/hairbrushes, headphones, etc.

What is dandruff?

Dandruff, also called seborrheic dermatitis, is not an infection and not contagious. Rather it is a scalp abnormality that causes dry, scaly flakes to be shed in excess. Another manifestation of seborrheic dermatitis that may affect infants more frequently is commonly called cradle cap. This scalp change appears as scaly scalp areas that have a greasy character rather than the dryness of classical dandruff (which is not usually seen in infants or toddlers).

What are the causes and risk factors of lice infestations and dandruff?

Lice infestation is a person-to-person transmission of a parasite via contaminated agents (fomites) that facilitate transfer of the agent. Such agents would include caps, combs/hairbrushes, pillows, and headphones. Lice infestation is highly contagious and is very common in the toddler and early childhood grades. Between 6-12 million children from 3-11 years of age will develop a lice infestation annually. Crowded conditions, day care centers, and female gender (more likely to share hair brushes/combs) are risk factors. For reasons not fully understood, African-American hair is less likely to support a lice infection.

The presence of dandruff is extremely common. Many teen and adults have experienced such scalp changes. Some experience repeated exacerbations of the condition and may someday to be demonstrated to have a genetic predisposition to dandruff. Seborrheic dermatitis (cradle cap) is similarly a very common scalp situation found in the infant and toddler. Similar to dandruff, the situation may be of minimal consequence to some and a repeated experience to others. Neither condition reflects poor hygiene.

Medically Reviewed by a Doctor on 5/17/2017

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