1. Lice or Nits (Most Common)
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What it looks like:
Nits: Tiny white, yellow, or brown specks glued firmly to the hair shaft, usually within ¼ inch of the scalp. They don’t brush off easily (unlike dandruff).
Live lice: Small, tan or grayish bugs (about the size of a sesame seed) that move quickly and avoid light.
Other signs:
Itchy scalp (especially behind ears and neck)
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Red bumps or sores from scratching
Your child complains of “something crawling”
What to do:
Use a fine-tooth lice comb on wet, conditioned hair.
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Over-the-counter lice treatments (like permethrin or dimethicone) are effective.
Call the doctor if: Sores are infected (oozing, crusted), or OTC treatment fails after 2 applications.
2. Dandruff or Cradle Cap (Seborrheic Dermatitis)
What it looks like:
Flaky, white or yellow scales on the scalp that brush off easily.
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May look oily or crusty (in infants, this is “cradle cap”).
Other signs:
Mild redness
No intense itching (unlike lice)
What to do:
Use dandruff shampoo (with zinc pyrithione or selenium sulfide).
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Gently massage baby oil on scalp, then comb flakes away (for cradle cap).
No need to see a doctor unless it spreads to face/ears or becomes very inflamed.
3. Flea Eggs or Debris (If You Have Pets)
What it looks like:
Tiny white specks that fall off easily (unlike nits).
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May see actual fleas jumping or dark “flea dirt” (feces) that turns red when wet.
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