Where to Look for Lice First: Nape, Ears and Crown

Behind the ears – part the hair on the strip of scalp directly behind each ear and look at the first centimetre of hair. The nape of the neck – lift the hair at the back hairline, where the head meets the neck. The crown – part the hair at the top of the head, along the parting and around the crown whorl.

The ears and nape are the spots public health guidance names for nits. The crown is worth a look because it is close to the scalp and easy to reach, but don't stop there. Lice can be anywhere on the scalp, so a clear look at these three areas is a starting point, not the whole check.

Why Lice and Nits Collect Near the Scalp Lice feed on blood several times a day and die within a day or two away from a head. Female lice glue their eggs to the base of hair shafts, nearest the scalp, because the eggs need that warmth to hatch. According to the CDC, eggs that are still viable are usually within about 6 mm (¼ inch) of the scalp. That is why every check should focus on the roots rather than the lengths of the hair.

What You Will Need

Good daylight or a bright lamp (see the best lighting for spotting lice and nits) A fine-toothed detection comb – the NHS suggests buying one from a pharmacy or online Ordinary conditioner White kitchen roll or a tissue to wipe the comb on A magnifying glass, if you have one

Step 1: Look Behind the Ears Part the hair just behind one ear so you can see the scalp. Look for two things:

Nits – tiny oval specks stuck to the hair shaft close to the scalp. Live eggs are often brown or tan; hatched shells look white or clear. The NHS describes nits as brown or white and attached to the hair. Lice – greyish-white to tan insects up to 3 mm long, roughly the size of a sesame seed. They move quickly and away from light. Our guide to what an adult head louse looks like has more detail.

Repeat on the other ear.

Step 2: Check the Nape of the Neck Lift the hair at the back of the head and look closely along the hairline. Nits here are easy to miss if you only look at the top of the head.

Step 3: Check the Crown Part the hair at the top of the head along the natural parting and around the crown. Look at the roots for nits and anything moving.

Step 4: Comb the Whole Head A visual check of the hotspots will often miss lice, because they are small and move away from light. To confirm whether lice are present, comb the whole head:

Wash the hair with ordinary shampoo and apply plenty of conditioner. Detangle with a normal comb. Starting at the roots, draw the detection comb through each small section of hair to the ends, keeping the teeth touching the scalp. Wipe the comb on white kitchen roll after each stroke and look for lice. When you have finished, comb through the whole head a second time.

The NHS says this usually takes about 10 minutes for short hair and 20 to 30 minutes for long, frizzy or curly hair. For tight curls, braids or locs, see checking for lice in curly or thick hair.

White specks in the hair are a common worry. Dandruff, dry skin, hair product and nits can look alike at a glance. Here is how to tell them apart:

| Feature | Nits (lice eggs) | Dandruff, flakes or product | |---------|------------------|-----------------------------| | Attachment | Glued firmly to one side of the hair shaft | Loose on the scalp or hair | | Removal | Has to be slid off with fingernails or a comb | Falls or brushes off easily | | Location | Live eggs usually within about 6 mm of the scalp | Anywhere on the scalp or hair | | Shape | Even, oval, teardrop-like | Irregular flakes or blobs |

If a speck slides off easily, it is probably not a nit. If it stays stuck, compare it with our guide to what nits look like on hair shafts. Finding nits alone does not prove there are live lice now: nits more than about 6 mm from the scalp are almost always hatched or dead, according to the CDC. Our guide to live nits vs dead nits explains how to judge this.

This section follows UK NHS guidance. Treatment advice in other countries, including the US, differs, so check your local health service or pharmacist.

Wet Combing The NHS says you can remove lice and nits by wet combing, using the method above. To catch lice that hatch from eggs you missed, wet comb on days 1, 5, 9 and 13, then check again on day 17 that the hair is clear.

Medicated Lotions and Sprays If wet combing hasn't worked or isn't suitable, the NHS suggests a medicated lotion or spray from a pharmacy, supermarket or online. Some need repeating after a week. Check the pack to see whether it is suitable for the person being treated, including age limits, and ask a pharmacist if you are unsure – for example for a baby, or if you are pregnant or breastfeeding. The NHS does not recommend products containing permethrin, head lice "repellents", electric combs or plant oil treatments such as tea tree oil, because they are unlikely to work. Our head lice treatment reviews compare the main products.

Check Everyone You Live With The NHS advises checking everyone you live with or have close contact with, and treating anyone who has head lice on the same day. Only treat people who have lice. Don't use medicated products to prevent lice, as they can irritate the scalp.

School and Laundry In the UK, there's no need to keep a child off school because of head lice, and you don't need to wash laundry on a hot wash. In the US, the CDC says children do not need to be sent home early; they can be treated after school and return once treatment has started.

Most head lice can be managed at home. Speak to a pharmacist, or consider a professional head lice clinic, if:

lotions or sprays haven't worked – the NHS says to ask a pharmacist about other treatments the scalp looks infected from scratching, for example red, weeping or crusty skin – see a GP you can't tell whether what you're seeing is lice, nits or something else the hair is very long, thick or tightly curled and you can't comb it properly at home

Our guide on how to choose a head lice clinic explains what to expect.

Use this answer as one piece of evidence, not the whole decision. If you want a quick second check, start with the AI head lice checker, then compare your result with the wider AI Detection hub so you can see where this question fits in the bigger picture.

If what you are seeing still overlaps with common lookalikes, compare it with what do head lice look like in hair and what do nits look like on hair shafts before moving to treatment on guesswork alone.

When the evidence remains mixed after a better photo or repeat check, move from uncertainty to confirmation. The most practical escalation routes are How to Choose a Head Lice Clinic Near You and the Head Lice Clinic Locations hub.

If active lice becomes likely, use the shop treatment reviews and the review of the NitNOT Fine Tooth Comb as decision support rather than treating every doubtful sign automatically.