What should you know about head lice living on a human scalp?

Head lice are adapted to human scalp hair and do not live deep inside the skin. They move through hair near the roots, especially around the ears and the back of the neck. Their eggs are cemented to hair shafts, so they do not behave like loose flakes.

A scalp may itch because of the body’s response to bites, although itching can begin later or be absent. Head-to-head contact is the main route of spread. Learn more about [Head Lice](/conditions/head-lice/) and [Itchy Scalp](/symptoms/itchy-scalp/).

Part wet, conditioned hair into small sections and draw a fine-toothed comb from the roots to the ends. Wipe the comb after each stroke and inspect what it removes. Continue with the recommended schedule, since one session may not remove every egg or newly hatched louse.

If you use a medicated product, follow the label for application, rinsing, age limits, and repeat use. Do not combine products unless a clinician specifically advises it. Avoid sharing brushes, headwear, towels, and pillows, and check close contacts for live lice. See [Head Lice Treatment](/treatments/medical-dermatology/head-lice-treatment/).

Arrange a [GP Consultation](/treatments/consultations-and-assessment/gp-consultation/) if you cannot identify a live louse, if lice remain after following instructions, or if scratching causes sores, pus, crusting, increasing redness, or pain. Get urgent help for a severe allergic reaction to a treatment.

Ask whether the scalp finding is active lice, which removal method is suitable, how long to continue checking, and what could explain itching after no live lice are found.