Most people get an itchy scalp when they have lice. The itchiness is caused by an allergic reaction to the bugs’ saliva when they bite your scalp to feed on your blood. Some people describe the sensation as more of a burning or stinging feeling rather than itchy. And some people will have tiny red bumps on their scalp or back of the neck from the lice bites. However, we have seen plenty of people who are severely infested with lice and don’t itch at all, because they don’t have a reaction to the saliva. Another reason people may not itch is if they are taking allergy medications that reduce the itchy sensation. So don’t rule out lice just because your scalp doesn’t itch or you don’t have red bumps.