Does head lice cause itching worse at night?

Head lice feed on the scalp and can trigger an itchy reaction to their bites. Scratching may become more noticeable in bed when there are fewer daytime distractions. Look closely behind the ears and near the nape for live crawling lice or firmly attached nits close to the scalp. Nits can be confused with dandruff, but dandruff usually flakes away more easily.

Nighttime itching alone does not identify its cause. Dry skin, eczema, irritation from hair products, and other scalp conditions can also itch after dark. A close scalp inspection helps distinguish these possibilities.

Use a bright light and a fine-toothed lice comb to examine wet, conditioned hair in small sections. If you find live lice, follow the directions for an approved treatment and repeat the process as directed; combing can help remove lice and nits. Avoid sharing combs, brushes, hats, pillows, or towels until the household has been checked. Wash recently used bedding and clothing, and soak combs and brushes in hot water.

Arrange medical advice if you cannot tell whether the scalp findings are lice, if itching continues after correctly following treatment directions, or if scratching causes sores, crusting, swelling, or drainage. Seek prompt care for spreading redness, fever, or marked tenderness, which can signal a skin infection.

Ask whether the scalp findings are live lice, nits, dandruff, or another condition; which treatment suits your age and health; when treatment should be repeated; and how close contacts should be checked.