How Long Will My Head Itch After Lice Treatment? Why It Still Itches and What to Do About It

כמה זמן אחרי שטיפלתי בכינים הראש שלי ימשיך לגרד?

An itchy scalp is the first symptom of head lice that many people notice, and it’s the worst symptom of a lice infestation for many people as well. It can be very unnerving, then, when you’ve completed the second recommended head lice treatment … and your scalp still itches! This begs the question – how long will my head itch after lice are gone?

Why does your head still itch after a lice treatment? What does that mean? And how long will the itching last after a lice treatment?

It’s very common for the scalp and neck to remain itchy for three to five days after a successful lice treatment. There are a few reasons for this, but it’s perfectly normal. It’s also pretty simple to diagnose what is going on.

1. The scalp is dry from harsh lice treatment chemicals.

There are a variety of head lice treatments on the market—from all natural solutions, to prescription medications, and everything in between. Most of the prescription medications and over-the-counter lice shampoos use chemicals that can irritate and dry out the sensitive skin on the scalp (especially a child’s scalp). 

If you used a medicated head lice treatment, it’s very possible that the scalp is still itchy because it is dry and irritated.

There are several steps you can take to help soothe and moisturize an irritated scalp:

• • Use a moisturizing shampoo and/or conditioner designed for sensitive skin. You may want to find a brand that uses all natural ingredients to avoid any further irritation.

• Use natural and essential oils to heal and hydrate. Chamomile, jojoba, lavender, and rosemary oils are all great for healing the scalp. Add a few drops of essential oil to a tablespoon of a carrier oil (like coconut or almond oil), and massage into the scalp for a few minutes.

• Wait to wash the hair again if you can. Most shampoos strip natural oils from the hair and scalp. If you can stand to let the hair be greasy for an extra day or two, it will help replenish those natural oils.

• Avoid other hair products until the scalp is restored. If you normally use styling products on your hair, avoid them until the itching and inflammation is gone.

• Stay hydrated. Make sure you’re drinking enough water for your skin to stay as hydrated as possible.

2. Lice bites are still healing.

The main reason that head lice are so itchy is that they bite. Louse saliva creates an allergic reaction, similar to a mosquito bite, which results in an itchy red bump. A completely successful lice treatment may have removed every louse and nit, but those bites will still itch for several days.

In the meantime, you can ease the itch of healing lice bites with:

• A cold compress or ice pack to temporarily ease itching and reduce swelling.
• A low-dose allergy medication to combat the reaction your body suffers from lice bites.
• Witch hazel to soothe irritated skin and reduce swelling.  

For more on lice bites, see “Head Lice Bites: How to Identify and Treat Them” →

3. The treatment was ineffective. (i.e. You still have lice.)

No one likes to be the bearer of bad news, but it is possible that your lice treatment was ineffective and you still have head lice. 

There are several reasons that this could happen:

• You’re dealing with a strain of super lice. Most head lice in the U.S. is a strain of “super lice,” or lice that has שנית, גם אם אנו מזהים כיני ראש, אין צורך להיכנס לפאניקה. כיני הראש אינן מפיצות מחלות, אך הן מדבקות להפליא. אם זיהינו כיני ראש, עדיף להפריד בין בני משפחה שנדבקו ולהפחית את המגע ראש בראש עד לטיפול הסרת כינים. ישנם טיפולים ביתיים לכינים בראש, כפי שנפרט בהמשך, כך שהבעיה לא תמשך יותר מדי זמן. to the active ingredients in most OTC lice shampoos and medications. If your treatment relied on permethrin and/or pyrethrin, it may have been ineffective against super lice.

• The treatment was administered incorrectly. Oftentimes, parents or caregivers will make light use of a product or skip a second treatment, despite the product’s instructions. When this happens, it seems, initially, like the lice have been removed, but they “reappear” when nits hatch about seven days later.

• That all-natural solution wasn’t really a solution. There are several natural, healthy solutions that do treat head lice, but there are almost as many old wives’ tales that have never been proven effective. Make sure you know which natural solutions are proven to treat head lice.

If you think your first treatment was ineffective, conduct another lice check to see if you can find live lice and/or live nits cemented to hair follicles. If you do find evidence that lice are still living on the scalp, try a proven, safe treatment for removing head lice and follow the instructions perfectly.

For help choosing a treatment, see “9 Best Lice Treatments (and 4 to Skip)” →

4. You’re experiencing psychosomatic itching.

In other words: It’s all in your head. Psychosomatic itching is the reason that your scalp starts to itch and crawl when you read about, or look at pictures of, head lice. It’s even worse if you’ve been itchy and scratching for days (or even weeks) already.

At its core, psychosomatic itching is a symptom of anxiety and/or paranoia. If your scalp is healed and a lice check reveals no bugs or live nits, then you’re probably suffering from some anxiety over the lice you used to have.

If that’s the case, treat that itching like an anxiety issue, not a lice issue:

• Practice awareness. Take a minute to slow down and remind yourself that you treated the lice and they’re gone. Remind yourself that the itching is just in your head.

• Use a grounding technique like you would deal with any anxiety. Grounding techniques are meant to distract you from the unwanted feeling and help you stay in the present. Change your surroundings or create a sensory experience that you can concentrate on for a few moments.

Phantom itching after lice is not uncommon and, if you’re not dealing with other anxiety, will usually resolve in a few days.

Other Post-Treatment FAQs

The head lice experts at Novokid field a lot of questions about itchy lice and post-treatment best practices. Here are a few common questions:

How long after you get lice does your head start itching?

Most people don’t notice a crawling or itching sensation until they’re several weeks into a lice infestation. This seems counterintuitive, but one or two very small insects can easily pass unnoticed. It’s not usually until the third or fourth generation of nits have hatched that the population is noticeable and the bites really start to become intolerable.

How do you know when the lice are gone?

If itching is common for several days after a successful lice treatment, how do you know the lice are really gone?

First, we recommend using proven (by science), all-natural head lice treatments to avoid a dry, irritated scalp. Some of these treatments are as good or better than OTC shampoos, so they’re also more likely to be effective. 

Second, be sure to follow the directions exactly.

Once you’ve completed all of the recommended treatments (most solutions recommend a second treatment seven days after the first), comb through the hair with a במסרק בעל שיניים to check for insects and nits. If all of the insects and nits are removed, the lice are gone.

You will know for sure in a few more days when the bites stop itching. If no additional insects can be found and the itching stops, the lice are gone.

Can lice still be alive after treatment?

Yes. In fact, some head lice treatments don’t actually claim to kill lice, but rather to stun or slow them so they can be more effectively combed out. Even those treatments that do aim to kill lice don’t generally claim to kill 100% of insects.

Additionally, even fewer lice treatments kill nits. A treatment may kill the live insects, but the eggs are sturdy and will still hatch seven days later.

That’s why almost every lice treatment on the market recommends thoroughly combing the hair after the treatment to remove each louse and nit.

Will dead nits fall out eventually?

Empty, or dead, nits remain cemented to hair follicles after the louse hatches—usually fading to a more dull, gray color. They are not cause for alarm. You can comb them out with a special lice comb, but they will eventually fall out on their own as well. 

Can you do lice treatment 2 days in a row?

Parents and caregivers sometimes try to speed up the process, or try to “double down” on a lice treatment, by doing the second treatment the very next day. This is not effective.

Most lice treatment solutions include instructions and product for a second treatment seven to nine days after the initial treatment. This is because lice nits take about seven days to hatch and most lice treatments can’t kill nits. A good treatment will kill or help you remove juvenile and adult insects, but then the next generation of nits will hatch a week later.

The second treatment, then, is not a “just in case” treatment or an “extra boost” treatment. It’s designed and timed to kill or help you remove the next generation of lice before they lay another generation of eggs. Moving that second treatment up to the next day is a wasted effort.

Head still itchy after a lice treatment? No worries.

Our first line of advice to dealing with head lice is always, “Remain calm,” and it’s true with post-treatment itching as well. There will almost always be some itching for a few days after a successful treatment, because—at the very least—all of those bites are still healing.

You may also very likely be dealing with an irritated scalp and/or psychosomatic itching. 

If you find that your first treatment attempt was ineffective, make sure your second one is the best. The Novoki dry vapor treatment is a completely unique, all-natural, scientifically proven treatment for head lice. It is effective against super lice, gentle on the scalp, and very easy to administer—reducing user error.