What if head lice treatment does not relieve itchy scalp?

Itching can continue because live lice remain, eggs have not been managed as directed, or the scalp is irritated by scratching or the treatment product. It may also come from dandruff, eczema, contact irritation, or another scalp condition rather than lice. Finding a live crawling louse is more useful than relying on itch alone. A careful check with a fine-toothed comb and good lighting can help identify what is happening.

Review the product instructions, application time, repeat-treatment guidance, and whether close contacts were checked. Avoid applying extra doses, combining lice products, or using household chemicals on the scalp. Wet-comb the hair as directed and clean recently used personal items according to local health advice. Ask a pharmacist or clinician to confirm whether live lice are present and which product is suitable, especially for a child, pregnancy, sensitive skin, or a damaged scalp.

Seek prompt medical care for facial swelling, breathing difficulty, widespread rash, severe burning, pus, increasing pain, or fever after treatment. Arrange an assessment when live lice remain after correct use, itching is intense, or scratching has caused open sores. Persistent itch without live lice deserves evaluation for another scalp condition.

Are live lice present, or is the itch coming from irritation or another scalp condition? Was the product suitable and applied correctly? Is repeat treatment needed? How should household contacts and combing be managed safely?