Head lice infestation or Pediculosis capitis infestation is one of the commonest parasitic infestations affecting 6 to 12 million people in the United States alone annually.

However, worldwide the figures remain unknown since many cases go unreported.

Those at risk include school children, those living in overcrowded living conditions etc. Warm and moist climate is ideal for lice infestation.

Symptoms of head lice in children

Children, more often than not do not show any symptom of head lice infestation apart from scratching the head.

Intense itching of the scalp

One of the main symptoms of headf lice is intense itching of the scalp.

The louse feed nearly 5 times a day on the human blood from the scalp. They have an anterior part of the head that possesses hooklets that they can attach to the skin to suck out the blood.

As they sink in their hooklets into the skin there may be severe itching.

The bites and saliva of the lice leads to the activation of the human host immune system and sensation of “something crawling on the head” or itching.

Other symptoms of head lice

Other symptoms of head lice infestations include (1-6):

• There may be red bumps over the scalp, neck, and shoulders. They may ooze secretions or burst. These may be due to allergies to the lice or due to the secondary bacterial infestations of the bitten areas.
• Repeated scratching of the scalp leads to skin breakage and secondary bacterial infections. These infestations may be painful and may ooze or develop pus. Rarely in malnourished or severely ill patients these may turn into abscesses.
• Nits or eggs are visible as white, yellow specks near the root of the hair over the scalp. Live nits may also be the color of the hair of the host. These are glued tight and hard to remove. They are commonest at the back of the head and behind the ears.
• Lice are usually difficult to see as they can move very fast. They are visible only if there are a large number of them. A usual infection means no more than 10 to 12 live lice but may mean many hundreds of unhatched eggs.
• Most infestations especially in children do not lead to any symptoms unless severe.
• Some patients with severe infestations may present with fever, swollen lymph nodes (especially at the back of the head), rash, irritability and feeling of unwell.
• Lice are most active in the dark so there may be difficulty in sleeping at nights in severe infestations.
• Children with severe infestations have eyelash and eyebrow involvement.