A Closer Look at Lice Bites and Rashes with Pictures
Compare the bites of head lice, body lice, pubic lice, sea lice, and even bed bugs with multiple pictures of lice bites and rashes on children and adults.
Lice are small parasites that live, breed, and feed on humans. Many people with lice find bites and rashes on their neck, behind their ears, or even in their groin. When so many bug bites look so similar, how can you determine if what you have is a result of lice or something else?
This article takes a meticulous look at these bites and rashes (feel free to click a hyperlink):
Body Lice vs Bed Bugs
What Are Lice?
Lice are bugs that range from being microscopic at birth to about the size of a sesame seed as adults. Lice require a human host as they need to feed on human blood frequently. There are three types of lice that live on humans: head lice, body lice, and pubic lice.
A fourth type of lice making news these days is a new strain of head lice, called super lice. Super lice and regular head lice are virtually the same bugs, except super lice have mutations that make them very difficult to exterminate. These super lice are becoming the “new” strain of head lice. For the purposes of this article, we will treat the bites of regular head lice and super lice the same.
If your symptoms are only associated with your head, neck, and/or ears, you’ve probably got head lice.
Head lice is the most common type of lice these days by a landslide. They stick solely to the hair and near the head. They are occasionally found in facial hair, but only in severe cases. Head lice is NOT associated with poor hygiene. On the contrary, it does not matter how clean you are or how often you wash your hair; head lice are unphased by water, soap, and shampoo.
Head lice are a widespread problem in the United States, where it’s estimated that around 12 million kids get head lice every year! The largest number of kids affected are between the ages of 3-12, but head lice is also common among teens and adults.
Head lice are the only bugs that live in human hair. If you find multiple bugs in your child’s hair, the answer is yes, it is head lice.
The most obvious sign of head lice is finding bugs in the hair! Head lice are the only parasites that live in human hair. However, in the early stages of head lice, finding the bugs can be very difficult because they hide quite well in hair and scatter quickly. For instance, can you spot any lice hiding in this picture?
Here it is circled…
Head lice range from so small that they’re nearly invisible at birth to the size of a sesame seed when fully grown. They are tan to brown in color and often slightly translucent. They can actually be darker or lighter depending on their host’s hair or skin color.
Head lice are not dangerous and do not spread diseases, but they often make the person they are infesting supremely uncomfortable, not to mention head lice is quite contagious, easily spreading from person to person.
Head Lice Bites
Head lice feed on the scalp frequently, drinking human blood. Each time lice feed on your blood, a small amount of their saliva goes into your scalp. A little bit of this saliva goes unnoticed for most people, and no rash or bite marks are usually seen during this time.
After a month of this repeated feeding and injection, though, your body develops an allergic response to the lice saliva. This results in the emergence of small red bug bites or rashes on the neck, ears, and/or scalp.
Most people assume the appearance of lice bites is universal to all people, but they are not. Many people with head lice do not have any symptoms because their body does not develop an allergic reaction to lice saliva.
Lice Bites on the Neck
A telltale sign of head lice is small red bumps on the neck, also referred to as lice bites. For many people, this sign can show up even before itching begins.
Lice Bites Behind the Ears
The second most common place for lice bites is behind the ears and can extend to the lateral part of the neck.
Lice Bites on the Scalp
Some people develop several cyst-like bumps on their scalp, similar to acne. It is unclear whether these bumps are actually swollen areas that lice have fed (which are lice bites) or if it is an overall allergic reaction to lice saliva.
Lice Rash on the Neck and Ears
Most commonly, a blotchy, painless (or itchy) rash develops at the nape of the neck, slightly in the hair. The rash sometimes spreads to below the hairline. For a few people, this rash can extend down the entire neck.
The second most common rash is found behind the ears. A rash behind the ears is commonly bright red or blotchy red, extending to the lateral neck.
Lice Rash on the Entire Scalp
Some people end up with a red blotchy rash that covers their entire scalp.
Bites or Rash on the Shoulders or Upper Back
It is not typical for lice bites and rashes to extend past the neck. However, for those with more severe allergic reactions to lice saliva, the rash can extend to the shoulders and upper back (though head lice do not actually bite the shoulders or back, generally speaking).
If you find bites or rashes on your shoulders or back, it could be that you’re dealing with bed bugs rather than lice.
Sores and Scabs on the Scalp
Sores and scabs on the scalp are usually the consequence of severe scratching, when fingernails dig into the scalp so intensely that the outer layer of skin is removed. In rare cases, bacteria can enter into these scabs, and a bacterial infection on the scalp may follow.
Weeping of the Scalp
In severe cases of head lice, a clear or light pink fluid (called serous fluid) can drain from the scalp. This fluid is the body’s reaction to fighting off bacteria and healing the scalp. Unfortunately, when the clear fluid dries in the hair, the hair becomes glued together and matted, usually making the head lice issue more difficult to address.
Do Head Lice Bites and Rashes Hurt or Itch?
Some rashes and lice bites are extremely itchy and uncomfortable. It feels like an itch you can’t scratch enough to satisfy. Other people may not experience any itching, only the rash or bite marks. It all depends on how your individual body reacts to head lice and lice saliva.
Other Head Lice Signs and Symptoms
The earliest sign of head lice is finding lice eggs (also known as “nits”) in the hair. These nits are often mistaken for dandruff or dirt. What is unique about nits is that they are glued onto the hair strand. To learn how to examine your child for nits, check out our tutorial, How to Check Your Child’s Head for Lice.
Other common symptoms of head lice are itchy scalp, ears, and neck. Restlessness and intense itching at night is also a tell tale sign of head lice. To learn more about the other symptoms of head lice, read our article 17 Lice Symptoms with Pictures.
Head Lice Causes
About 90% of the time, head lice is passed directly from one person to another by head-to-head contact. Hugging, snuggling, and sleeping in the same bed are prime times for head lice to move from one person to another. Head lice can also be passed from inanimate objects, especially objects that come into contact with hair, such as brushes, hair accessories, or hats.
Ways to prevent head lice include:
- Avoid direct head-to-head contact like long hugs, sleeping in the same bed, or putting your head on another’s shoulders.
- Don’t share things that come in contact with hair, like brushes, hair accessories, hats, jackets, clothing, etc.
- Make your hair undesirable to head lice by using a lice prevention spray or lice prevention shampoo every day. The best ones are LiceLogic, Head Hunters, Rosemary Repel, and Ladibugs.
How To Treat Head Lice Bites
Because lice symptoms are the result of an allergic reaction to lice saliva, the only way to get rid of lice bites and rashes is to actually get rid of lice. As long as lice are on your head, you will continue to have bites and rashes. Using an anti-itch ointment on the neck may provide limited relief, but the bites, rashes, and itching will not fully subside until the lice is gone.
It is common to continue to have the appearance of lice bites and rashes for a few more days, even after lice is gone. It takes time for the body to heal and recover from the allergic reaction. All symptoms should go away within a week.
How to Get Rid of Head Lice
Super lice and regular head lice are virtually the same bugs, except super lice have mutations that make them (and their eggs) very difficult to kill. These super lice are becoming the “new” strain of head lice.
Super lice and regular head lice have all of the same signs and symptoms, except super lice cannot be killed through standard treatments.
There are only a handful of treatments that work to kill BOTH head lice and super lice, and most are currently only available online.
DO NOT run to the store and pick up a “popular” lice treatment. Those are usually among the very worst at killing lice, so don’t be fooled by big name brands and hollow promises of “killing super lice and eggs” on the treatment box.
For years, the only places that you could find a lice treatment kit that killed the new super lice was at a professional lice center. But, fortunately, many of these professional centers have started selling their products online.
These treatments kill BOTH lice and super lice.
(A quick disclosure: these are affiliate links, and I earn a commission from qualifying purchases; however, all of my reviews are based on the quality of the products)
The Ladibugs Lice Elimination Kit comes with a serum that kills both lice and super lice. It also comes with an enzyme mousse that helps loosen lice eggs, making them much easier to remove. This is a one-and-done kit, which means you have everything you need for one person in one kit. The enzyme mousse can be used multiple times over several days to remove lice eggs.
How to Get Rid of Head Lice
- Use a treatment that works on BOTH lice and super lice such as Ladibugs, Lice Clinics, Head Hunters or Fairy Tales.
- Remove all lice eggs from the hair with a special lice comb, such as the Nit-Free Terminator Comb.
- Check all family members for head lice with a lice comb or treat all family members with an enzyme shampoo like LiceLogic Clear & Free Shampoo.
- Keep checking with a lice comb and/or retreat 10 days later, not a week later.
Lice eggs on the head hatch after 7-10 days, so if you retreat or recheck after only a week, you may miss something that hasn’t hatched.
- Clean your house using the following principles as a guide or check out our article Lice Cleaning Checklist to Get Rid of Lice in Your Home.
Focus on cleaning items that have been in contact with the lice-infested individual within the last 48 hours. Lice cannot live longer than 48 hours on household items.
Do Not Use Lice Sprays
Lice sprays do not work on super lice. Multiple scientific studies have shown that that almost all lice in the US are resistant to the pesticide found in lice sprays. The only lice sprays that work for killing super lice are enzyme lice sprays like LiceLogic Clear & Free All Purpose Spray.
You can vacuum surfaces such as couches and mattresses.
Clean Your Brushes
Soak hair brushes, combs, and hair accessories (such as hairbands, clips, and headbands) used by the person with lice in hot water (135° F or greater) for at least ten minutes. (I do not recommend boiling brushes and combs, however, because they will melt.)
Items in the Dryer
Put items in the dryer for forty minutes on high heat.
Bag Items for Two Days
Lice can’t live without blood for very long, so anything that could have lice on it will be safe to use again after 48 hours. If an item is something that you cannot run through the dryer, like a favorite stuffed toy or delicate clothing, you can seal it away in a bag for a couple days instead.
Don’t Forget Carseats
Vacuum all your car seats if whoever had lice has been in the car recently.
What About Prescriptions for Lice?
Most prescription lice treatments use pesticides similar to the ones you’d find in over-the-counter treatments. They’re just larger doses or you’re supposed to keep them on for longer periods of time.
Since most lice these days are resistant to pesticides, it doesn’t matter how high the dose or how long you leave them on; they won’t work to get rid of lice! I would never use a prescription lice treatment on my own children or recommend one to you.
If you are someone who bathes at least weekly and do not live in a homeless camp, you do not have body lice.
Body lice is the least common type of lice in developed countries. It is associated with poor hygiene and is usually only seen among those living in crowded situations with limited access to bathing facilities, such as homeless and refugee camps. If you are someone who bathes regularly, it would be extremely rare for you to have body lice.
Unlike head lice, body lice live primarily on clothing, and only come in contact with skin when feeding, so they are usually only found in the clothing, bedding, and personal items of the infested individual.
Body lice CAN transmit diseases such as epidemic typhus, trench fever, and other bacterial infections.
Body Lice Bites
Body lice bites can be found anywhere on the body, but they are most prominent in areas near the seams in clothing. This is a picture of body lice bites (though usually lice bites on the neck are head lice related).
Much more common than body lice are bed bugs and fleas. Bed bugs, like lice, are growing increasingly resistant to pesticides and are increasing in number. If you have a rash on your body, you may be dealing with bed bugs rather than body lice.
Bed Bug Bites
This article doesn’t cover bed bugs, but here is an image of bed bug bites for comparison:
Other Signs and Symptoms of Body Lice
The main symptom of body lice is a constant, intense itching everywhere on your body. It’s like having hundreds of mosquito bites all over.
Just like head lice, each time body lice feed on your blood, a small amount of their saliva goes into your skin. Your body’s allergic reaction to that lice saliva causes the fierce itching.
Another significant sign of body lice is that the waist, groin, and upper thighs will become darker over time, as another reaction to continuous lice bites.
Body Lice Causes
If you shower at least weekly and wash your clothes regularly, you are not at risk of getting body lice. Body lice is spread through contact with infested individuals, clothing, or other infested inanimate objects.
How to Get Rid of Body Lice
Body lice is significantly easier to treat than head lice.
- Shower or bathe regularly
- After bathing, put on clean clothing
- Wash your infested clothing and items in hot water (>130° F), and then put them in the dryer on high heat for forty minutes.
Pubic Lice (Crabs)
Pubic lice, also known as “crabs,” live in course hair, usually pubic hair. However, pubic lice can make their way into eyebrows, beards, and chest hair. They can also (rarely) infest eyelashes. Pubic lice is an STD and is usually only passed during intercourse.
Pubic Lice Bites
Pubic lice bites appear similar to head lice and body lice lesions, except they are generally only found in genitals and the genital area. If you have “bites” on your genitals, you likely have pubic lice.
How Do You Get Pubic Lice?
Pubic lice is almost always spread from sexual contact. If a child is found to have pubic lice, it may be an indication of sexual abuse. If you have pubic lice, you should be tested for other STDs as well.
How Do You Get Rid of Pubic Lice?
- Ideally, shave your pubic hair, if possible.
- If not, use a lice treatment to kill pubic lice.
- Remove all lice eggs from the pubic hair with a metal comb or your fingers (you don’t have to do this if you shave your pubic hair).
- Put on clean underwear and clothing after treatment.
- Keep checking with a lice comb and/or retreat 10 days later, not a week later.
Lice eggs on average hatch after 7-10 days, if you retreat or recheck after only a week, you may miss something that hasn’t hatched.
- Contact all sexual partners from the last month and let them know they should get checked for pubic lice.
- Get yourself checked for other STDs.
- As with head lice, clean your house items using the following principles:
Focus on cleaning items that have been close contact with the body within the last 48 hours.
Wash and Dry Clothing in the Dryer
Wash on high heat (> 130° F) and dry for forty minutes on high heat all clothing and personal items that have been in close contact with the skin.
Bag Items for Two Days
Lice can’t live without blood for very long, so anything that could have lice on it will be safe to use again after 48 hours. If an item is something that you cannot run through the dryer, you can seal it away in a bag for a couple days.
Sea lice are not actually lice bugs, but a skin rash caused by jellyfish larvae. Also known as “seabather’s eruption,” it is caused by parasitic jellyfish that live in the ocean and feed on fish (not humans).
However, these parasites can leave a nasty rash if they get trapped underneath your swimming suit and rub against your body. The more they rub, the more they “sting you” and inject their toxins into your skin.
Some people have severe reactions to sea lice, but most people are just left with a nasty itchy, burning rash on the areas of their body underneath the swimsuit.
How to Treat Sea Lice Rash
- Take off your bathing suit and take a soapy shower.
- Wash and dry your swimming suit on the hot cycle to kill any remaining jellyfish larvae.
- Wait the itching out; it will improve over time.
- Anti-inflammatories like Ibuprofen or antihistamines such as Benadryl, may decrease the itching and pain. Hydrocortisone cream and calamine lotion may offer some relief as well.
- If the reaction continues to be severe, contact a doctor.
What to do next…
Of all of these types of lice, you are most likely to have head lice, especially if your symptoms are associated with your head, neck, or behind the ears. Head lice are the most common type of head lice by millions.
Unfortunately, head lice are also the most evolved, mutated, and difficult to get rid of because most head lice these days are the stronger super lice. Make sure the treatment you use is effective against both lice and super lice.
I hope these examples of the bite of head lice, body lice, pubic lice, and sea lice will help you in identifying what you’re up against so you can get back to feeling better as soon as possible!
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