When should you worry about itching worse at night if you have head lice?

Head lice feed on the scalp and can trigger an itchy reaction. The sensation may feel stronger at night when there are fewer distractions. Check the hair close to the scalp, especially behind the ears and at the nape, for live crawling lice or firmly attached eggs. Itching alone cannot confirm the cause, because scalp irritation, eczema, and product reactions can feel similar.

Use a fine-toothed lice comb on wet, conditioned hair and follow the product instructions for any recommended treatment. Avoid sharing combs, hats, pillows, or hair accessories until the household check is complete. Wash recently used bedding and clothing according to the care label. Do not apply repeated insecticide treatments or household chemicals to the scalp without professional advice.

Arrange a medical review for sores that are painful, oozing, crusted, or becoming more red; swollen glands; fever; or a rash spreading beyond the scalp. Ask a pharmacist or clinician to check the diagnosis if live lice are not found, treatment irritates the scalp, or itching does not settle after the recommended treatment plan. Urgent help is appropriate for facial swelling or trouble breathing after a product.

Ask: How can we confirm that live lice are present? Which treatment suits my age and scalp? When should combing or treatment be repeated? Could another scalp condition explain persistent itching? What signs would suggest a secondary skin infection?