Lice in Hair vs. Dandruff – What’s The Difference?

Woman with lice on hair.

If like me, you have felt the itch of something not quite right on your scalp, chances are you’ve wondered whether you have lice or dandruff. While both can be pretty uncomfortable and embarrassing, the good news is that there are ways to treat both, if you know which one you have. 

Having lived through the uncertainty myself, I have done some digging and am sharing what I have found out to help answer the question once and for all: How can you tell the difference between lice in a hair vs. dandruff?

While lice and dandruff can sometimes look similar, they are, in fact, different conditions. Lice are an infestation of parasites that feed on blood and cause itching. Dandruff is a skin condition that causes the top layer of skin on the scalp to shed too quickly, occasionally causing itching.

Both lice and dandruff look like white specks on the scalp, depending on the lice’s development. Both are itchy, and both seem to appear from nowhere, and while nobody likes an itchy head, there are ways to tell the two apart, which will help you get the treatment you need.

Let’s look at both lice and dandruff in more detail so you can tell the difference, and let’s also explore the treatment and prevention options available for you.  

(Please chat with your medical professional before using the treatment for any condition, skin or other.)

What’s the Deal with Dandruff?

Woman with long hair and dandruff on her black shirt.

Dandruff is a chronic skin condition that causes the top layer of the skin on your scalp to shed too quickly. It makes your scalp dry and itchy and means that tiny flakes of skin come loose and sometimes fall off.

The most common sign of dandruff is a snowy appearance on your shoulders and clothes. Extremely itchy dandruff is commonly caused by yeast.

The most common symptoms of dandruff include:

  • Flaky skin
  • Skin that is either too oily or too dry
  • Itchy scalp
  • Snowy white or yellow flakes on clothes
  • Red patches on the scalp
  • Symptoms that get worse in dry or cold weather
  • A small amount of temporary hair loss

Laboring with Lice?

Mother treating daughter's hair against lice through a special comb.

Lice live on the scalp and feed on human blood. (Am I the only one picturing adorable little vampires up in my hair?) Unlike those good-looking fantasy creatures, though, lice do cause bad itching and are highly contagious. Thankfully, they don’t spread diseases, but they do need to be taken care of once on your head.

Children are most likely to get and spread lice because of their need for physical touch, close contact, and sharing items like hairbrushes. That means that families with children are more likely to be affected than those without.

The most common symptoms of lice include:

  • Tiny black spots on the scalp or in the hair
  • Extremely itchy scalp
  • Teardrop-shaped eggs in the hair (this is what is often mistaken for dandruff)
  • Swollen lymph nodes
  • Red spots on the scalp from continuous scratching

The 5 Easiest Ways to Tell the Difference Between Lice and Dandruff 

  1. The color: Lice eggs are whiteish in color, while the lice themselves look like black or brown spots or tiny bugs. Dandruff flakes are white or yellow.
  2. Where it is: Lice sticks to the hair while dandruff falls off. Lice eggs are also on the hair and not on the scalp.
  3. Itching: Both lice and dandruff itch. People with lice may feel bugs crawling on their scalp, while dandruff sufferers may feel the symptoms worsen when their scalp is dry.
  4. Level of contagion: Dandruff is not contagious, while lice are highly contagious.
  5. Lymph node complications: Dandruff does not cause complications with the lymph nodes, whereas a lice infestation can. This is caused by excessive scratching, which breaks the skin and results in a bacterial infection.

Less Common Symptoms and Complications with Dandruff

Closeup of woman with dandruff on her shoulders.

For most people, dandruff is usually a minor inconvenience or a pesky irritation at most. But for a few patients, the skin condition on the scalp can lead to further skin problems elsewhere on the body. 

You may find yourself developing flaky or scaly skin in areas like your face, neck, ears, or neck, as well as your scalp. These patches will be dry, red, itchy, or painful. However, both conditions can cause embarrassment and need to be cleared up as quickly as possible.

The Best Treatment Options for Dandruff

Treatment for dandruff can be as simple as using anti-dandruff shampoo once or twice a week. If you find that your scalp is drier than usual, stick to using the shampoo only once a week.

If your dandruff doesn’t seem to be getting better with the anti-dandruff shampoo, it may be time to chat with a dermatologist. Lingering dandruff could be caused by a yeast infection on the scalp, eczema, or even an autoimmune condition, so best to consult a professional.

The Best Treatment Options for Lice

  • Most lice infestations can be dealt with by using a treatment or two of over-the-counter insecticidal shampoo. When treating lice, you do need to comb the nits out of the hair, too, and be sure to closely follow the directions on the packaging of your shampoo.
  • If you find that your friendly bloodsuckers just don’t want to leave, consult a doctor for an alternative prescription.
  • Keep yourself and anyone else you may have infected in isolation until the infestation is dealt with.

Best practices for treating your home for lice:

Girl's hair being treated and cleaned for lice.

The Centre for Disease Control and Prevention recommends these 4 ways to keep lice out of your house:

  1. Wash all clothing, bedding, and other linen at 130°F or hotter
  2. Vacuum all carpets and mats in your home
  3. Soak brushes and combs in 130°F water for at least 10 minutes
  4. Try to avoid using poisons or insecticides in your home

Preventing Dandruff is Super Simple

Although most of us will suffer from a bout of dandruff at least once in our lifetime, it can be prevented by regularly washing your hair. If you tend to get it reasonably often, try to understand your triggers and avoid them.

Triggers could include things like cold or dry air, diet or allergies/sensitives.

Preventing Lice is as Easy as One, Two, Three

To prevent an infestation of lice, keep these three rules in mind:

Mother treating daughter's hair with a leave-in treatment against lice.
  1. Avoid sharing brushes and combs, pillows, and blankets
  2. Limit close contact with children or other high-risk individuals
  3. Treat family members with lice immediately 

So, in Summary

Dandruff remains white or yellow and falls easily from the hair. It is itchy, but not usually extremely so, and it can generally be treated with anti-dandruff shampoo.

Lice eggs are white in color, but once hatched, they are brown or black. They stick to the hair and have to be combed out. Having lice is extremely itchy, and you can sometimes feel the bugs crawling on your scalp. It can usually be treated with over-the-counter shampoo and a thorough treatment of the house.  

It’s important to remember that if you start to experience any additional symptoms or your condition, whether its lice or dandruff, persists, you should book an appointment with your doctor.

Complications like additional skin conditions or lymph node infections need the input of a professional.  

If you have a suspiciously itchy head, take a closer look. It may be tiny vampires having a party on your scalp, or it could just be some dry skin in need of some TLC.


Medical News Today: How to tell the difference between lice and dandruff

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