Itching on the scalp, especially behind the ears and at the nape of the neck
A tickling or crawling feeling in the hair
Small red bumps or sores on the scalp, neck, or shoulders
Trouble sleeping from scalp itching
Finding live lice in the hair or on the scalp
Finding nits attached firmly to hair shafts close to the scalp
Nits that do not brush off easily like dandruff
Scratching that leads to irritated or inflamed skin
Seeing tiny tan, brown, or gray insects moving in the hair
Checking with a fine-tooth lice comb under bright light to confirm lice or nits