Does head lice cause itchy scalp?

Lice live close to the scalp and feed there, while their bites can provoke irritation. Itching may be felt across the scalp or concentrated behind the ears and around the nape. Some people notice scratching before they see a louse. A careful inspection may reveal live crawling lice or small nits attached to individual hairs close to the scalp.

An itchy scalp has many possible explanations. Dandruff, dry skin, eczema, psoriasis, contact irritation from hair dye or styling products, and fungal infection can look or feel similar. Itching by itself cannot confirm head lice.

Check wet, conditioned hair under strong light, separating it into narrow sections and combing from the scalp outward with a fine lice comb. If live lice are found, use a suitable treatment exactly as its instructions describe and repeat it when directed. Check household and close contacts, and do not share brushes, hats, hair accessories, or bedding while the problem is being addressed.

See a clinician or pharmacist if you are unsure whether you found lice or nits, if itching remains after treatment, or if a child is too young for a product you are considering. Get prompt care when scratching has caused painful sores, pus, spreading redness, fever, or swollen glands.

Ask how to distinguish nits from flakes, which treatment is appropriate, whether close contacts need checking, how to clean combs and bedding, and when persistent itching should be reassessed.