How common is itching worse at night in head lice?

Head lice feed on the scalp and their bites can trigger an itchy reaction. Scratching may be more noticeable at night because the person is still and has fewer distractions. Look closely behind the ears and at the nape for live crawling lice or firmly attached nits near the scalp. Flakes and product residue tend to brush away more easily than nits, so careful inspection in bright light is helpful.

Some people have little itch at first, while others develop marked irritation. An itchy scalp can also result from dandruff, eczema, a product reaction, or infection, so a confirmed finding is more useful than the timing of itch.

Use a fine-toothed lice comb on wet, conditioned hair and check the comb and scalp systematically. If live lice are found, follow the directions for an appropriate pharmacy or clinician-recommended treatment and repeat it only as instructed. Check close household contacts, avoid sharing combs, brushes, hats, or bedding, and wash recently used items according to product guidance. Do not use multiple insecticidal products together.

Ask a pharmacist or clinician for help if you cannot tell whether you found lice, symptoms continue after correctly following treatment, or the scalp is too sore to examine. Seek prompt care for spreading redness, pus, severe swelling, fever, or broken skin that is becoming more painful, as scratching can allow infection.

Ask how to distinguish a nit from a flake, which treatment is suitable for the person’s age and hair, when a repeat application is needed, and how to manage itch while the scalp recovers.