How Do I Know If I Have Lice?

Reviewed on 10/19/2022
A nurse checking a girl's head for lice
Head lice and body lice may cause symptoms such as difficulty sleeping (when head lice scratch the most), feeling something moving or tickling in the scalp and hair, sores on the head, rash on the body, thick and discolored skin in infested areas, or sores on the body from scratching.

Lice are parasites that feed on human blood and can be found on people’s bodies. 

There are three types of lice that live on humans:

  • Pediculus humanus capitis: head louse, lives on the scalp and in the hair
  • Pthirus pubis: pubic louse, also called “crabs,” lives in pubic hair, eyebrows, eyelashes, armpits, facial hair, and other areas
  • Pediculus humanus corporis: body louse, feeds on the body and can live in clothing (uncommon)
    • The only type known to spread disease

You may be able to know if you have lice with a visual inspection of the area where you feel itching. You can sometimes see adult lice or nits (louse eggs) with the naked eye, but lice may be difficult to see unless they are engorged with blood from a recent meal. 

If head lice are suspected but you cannot see them, a fine-toothed louse comb may help identify live lice. Sometimes, a magnifying lens may be needed to see them. 

If you cannot see lice, other signs you might have lice depend on the location of the lice. Itching is a common symptom of all types of lice. 

In addition to itching, which may be intense, symptoms of head lice include: 

  • Difficulty sleeping: head lice are most active in the dark
  • Feeling something moving or tickling in the scalp and hair
  • Sores on the head from scratching that may become infected

In addition to itching, which may be intense, symptoms of body lice include: 

  • Rash on the body
  • Thick and discolored skin in areas infested for a long time
  • Sores on the body from scratching (can become infected)

What Is the Treatment for Lice?

Home remedies can be used to treat itching caused by lice bites but they do not get rid of the infestation. The infestation needs to be treated. 

The first treatment for lice infestations is to improve the personal hygiene of the infested person. Launder clothing, bedding, and towels used by the infested person with hot water (at least 130°F/54.4°C) and machine dry on the hot cycle. After that, both over-the-counter (OTC) and prescription shampoos and medications may be used.

Over-the-counter lice medications include:

  • Pyrethrins combined with piperonyl butoxide (A–200, Pronto, R&C, Rid, and Triple X)
  • Permethrin lotion, 1% (Nix)

Prescription head lice medications include:

  • Benzyl alcohol lotion, 5% (Ulesfia lotion)
  • Ivermectin lotion, 0.5% (Sklice)
  • Lindane shampoo 1%
  • Malathion lotion, 0.5% (Ovide)
  • Spinosad 0.9% topical suspension (Natroba) 

Excessive scratching can lead to sores and infections which may need prescription antibiotics. See a dermatologist if you suspect you have lice bites. 


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What Are Home Remedies for Head Lice?

Some home remedies recommend applying oils, mayonnaise, or vinegar to the head or body overnight to suffocate the lice. These remedies don’t always work and can be messy and time consuming. Talk to your doctor before trying any home remedy to get rid of lice. 

Natural home remedies will not get rid of lice but may help relieve itching caused by lice bites: 

  • Wash the area thoroughly with soap and water
  • Apply an ice pack wrapped in a towel to the affected area 
  • Apply Aloe vera gel to the bites
  • Apply apple cider vinegar to the bites
  • Soak a cotton ball in witch hazel, apply to the affected area and let sit for 10 minutes
  • Mix 1 teaspoon of baking soda with 3 teaspoons of water, apply the paste to the affected area and let sit for 10 minutes. Rinse. Repeat as needed. 
  • Pat lemon juice on the affected area (lemon juice can make the skin sensitive to sunlight so avoid the sun)
  • Make a fine paste with oatmeal and water, apply to the affected area, let sit for 20 to 30 minutes, and rinse with water. Repeat for a couple of days. Or mix 1/2 cup of colloidal oatmeal into a bathtub filled with warm water and soak for 10 to 15 minutes. 
  • Apply a cucumber slice to the affected area and let sit for 20 to 30 minutes.
  • Moist, cool tea bags may ease swelling and itching. Cool a moist tea bag in the refrigerator, and place it on the affected area for 15 minutes. 

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Reviewed on 10/19/2022

Image source: iStock Images