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Hair Casts vs Head Lice. How to tell the Difference.

03 October

Hair Casts vs Head Lice. How to tell the Difference. First of all the fail-safe way to tell the difference between a nit and a hair cast, is that hair casts are friable, or easily crumbled, when you crush them between your fingers.  Furthermore you could never crush a nit, as lice nits have a hard shell!

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Hair Cast Not Head Lice

Also hair casts are often shaped like little tubes that can slide up and down the hair shaft.  Although hair casts often encircle the hair shaft, they do not have the “super-glue” that attaches nits to the hair shaft.

In addition hair casts are always “opaque”, or white and cloudy in appearance, whereas nits are always clear or shiny.

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Hair Casts vs Head Lice. How to tell the Difference.

Hair casts are sometimes called  “pseudo-nits” because they are often mistaken for nits.

In fact Hair casts are a natural and normal product of the hair follicle (not a medical condition!!) and the consistency of hair casts like ear-wax.  We see hair casts in about 10% of our NitWits Belmont clients.  This is why we like the OMG Conditioner combing technique with the OMG Comb, using OMG Head Lice Conditioner Solution.  Because, when using OMG Conditioner hair casts always become invisible, and blend in with the white color of the  OMG conditioner.

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Hair Casts vs Head Lice. How to tell the Difference. Recently at Nitwits we have had several of clients sent to us by their school nurse who had “hair casts” instead of head lice. 

Hair Casts vs Head Lice. How to tell the Difference.We see hair casts in about 10% of our NitWits clients.  We have had a number of children sent to Nitwits with a diagnosis of head lice from their school nurse, pediatrician or dermatologist. While these students have a misdiagnosis of head lice, in fact they have hair casts and not head lice. Some hair casts can come in the shape of a nit and can look like nits. The big difference is that you can easily slide hair casts off the the hair shaft. Whereas nits are firmly glued to the hair shaft and cannot slide off.
Hair Casts vs Head Lice. How to tell the Difference.

Hair Casts vs Head Lice. How to tell the Difference.

According to this study in the Journal of Trichology “Hair casts, or pseudo-nits, are 2-7 mm long, discrete, firm, shiny, white, freely movable tubular accretions that encircle the hair shafts of the scalp. Dermatological examination shows white cylinders, easily deployable, located distal, medial and proximal to the hairs, especially on the occipital and parietal regions, bilaterally [Figure 1] Capillaroscopy reveals a cylindrical and hyaline mass involving the hair shaft [Figure 2].”
Hair Casts vs Head Lice. How to tell the Difference.

Hair Casts vs Head Lice. How to tell the Difference.

 

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