Can Lice Be Mistaken for Dandruff?

Lice and dandruff both lead to itchy skin on your scalp. But they are very different conditions.

An itchy scalp is an annoying problem that no one enjoys. You want to fix it fast but you might not know what’s causing the itch. It could be dandruff or it might be lice. 

How can you tell the difference between lice and dandruff? Learn more about the symptoms and treatments for lice and dandruff. 

Lice and dandruff both lead to itchy skin on your scalp. But they are very different conditions.

What are lice?

Lice are tiny parasitic insects that live on your scalp. They bite your skin to feed on blood. The bites are irritating and cause itching. 

What is dandruff?

Dandruff is a condition where the skin on your scalp is flaky and itchy. The white flakes of skin that are shed from your scalp can be seen in your hair or clothing. 

Lice and dandruff might feel similar but there are a few key differences between the two.  

Symptoms of lice

If you have lice, the main symptoms will be the itching caused by the bites on your skin. 

Other symptoms might include: 

• A feeling like something is moving in your hair.
• Difficulty sleeping due to itching and the lice crawling on your scalp at night
• Sores on the head caused by scratching.

If you examine your head, you can see signs of lice on your hair and skin. 

The telltale clues that you have lice are:

• Eggs: Also called “nits,” lice eggs look like small seeds. They can be white or brown. They are attached to the hair shaft close to the skin of the scalp. 
• Adult lice: Adult lice are tiny, no bigger than a sesame seed. They are light brown. They move very quickly and you can see them crawling around your scalp. 

Symptoms of dandruff

The main symptom of dandruff is the visible flaking of skin from your scalp. Your head may feel itchy or dry, as well.

Lice and dandruff have very different causes. 

Causes of lice

You get lice from close contact with a person who already has lice. Head to head contact is the most common way to transfer lice from one person to another. Contrary to myth, lice cannot jump. Close contact is the main way they move from person to person.

You can also get lice from objects that a person with lice has put on their head, such as hats, hairbrushes, scarves, and pillowcases.

Causes of dandruff

There is no explanation for dandruff that isn't caused by another condition. Doctors only know that it is very common. It is not harmful or contagious and won’t lead to hair loss. Still, people find it annoying, uncomfortable, and sometimes embarrassing.

There are different things to look for when you are trying to figure out whether you have lice or dandruff. 

How to diagnose lice

You can diagnose lice at home. You should examine your scalp for the signs of lice, including eggs attached to the hair shaft. Nits are firmly attached to the hair so you can’t brush them away easily.

The area behind your ears and near your neck is often where the eggs are the most common.

Seeing live adult lice moving around is the other way to diagnose lice. If you can’t spot them on your head but suspect they are there, you can trap adult lice by running a fine-tooth comb through your hair.

How to diagnose dandruff

You can tell you have dandruff from the flaking and itching that characterize the problem. However, simple dandruff isn’t the only cause of flaking and itching.

You may need to see your doctor to rule out other skin conditions such as:

• Eczema: A common, chronic skin condition that causes inflammation, itching, and flaking.
• Contact dermatitis: A rash due to exposure to some type of irritant.
• Seborrheic dermatitis: Also called “cradle cap,” this causes greasy looking scales on the head, as well as inflammation.
• Psoriasis: A condition where skin cells grow too quickly and develop into plaques that can itch and flake.
• Ringworm: A fungal infection that causes red, itchy patches on the skin.

Since lice are parasites and dandruff is a skin condition, they each require different treatment. 

Treatment for lice

You can buy over the counter treatments for lice at most drug stores. 

The two main ingredients for getting rid of lice are:

• Pyrethrins combined with piperonyl butoxide (found in brand name Rid)
• Permethrin lotion, 1% (found in brand name Nix)

It is important to follow the package direction for these treatments for them to be effective. Using a fine-tooth comb to remove lice and nits is also helpful.

If over-the-counter treatments don’t work, you can ask your doctor for a prescription for a stronger formula.

Treatment for dandruff

Over-the-counter dandruff shampoos are very effective at relieving dandruff symptoms.

Look for shampoos that contain these ingredients:

• Ketoconazole
• Salicylic acid 
• selenium sulfide

Make sure to follow the directions on the bottle since some shapes need to stay on your scalp for some time and others can be rinsed immediately.

If dandruff doesn’t clear up with non-prescription shampoos, or if your symptoms get worse, contact your doctor to ask about reasons for your dandruff.