As Stephen broods on the smell of his decade-long infatuation, and the effect of her body on her fabric, he is interrupted by the piercing sensation of a louse.
Stephen has been pleasurelessly indulging in recollections of the rough and sexually loose regions of the city which he himself used to frequent. Stephen insists to himself that it is inappropriate to think of her image in the same "secret and inflaming" manner that he contemplates the young wives "gaily yielding to their ravishers" (253).
"That was not the way to think of her. It was not even the way in which he thought of her. Could his mind then not trust itself? (253)
Stephen seems to consider her image unworthy of contamination by the "monstrous reveries" of his mind (95). He reassures himself that he never though of her in the evil way he had previously reduced women to sinful machines, before his anonymous confession. Although he has now given up on mortifying his senses, he apparently still considers his sexuality to be a low thing.
Just as Stephen finds himself being mentally corrupted by imagining her sensually, "the tepid limbs over which his music had flowed desirously," the lice recall to him his physical corruption (254).
"A louse crawled over the nape of his neck and . . . the tickling of the skin of his neck made his mind raw and red. (254)
Much as lice were said to spontaneously generate from human sweat by medieval philosophers, "His mind bred vermin. His thoughts born of the sweat of sloth" (254). In other words, Stephen considers his own thoughts to be equitable with lice.
Although Stephen has rejected piety in favor of art, he considers himself weakened by sin. This influences his actions; he decides in the end of this moment that if she is "too good" for him, she should "go and be damned to her. She could love some clean athlete who washed himself every morning" (254).
This historical perspective on lice is really interesting, and certainly relevant to this moment. I'd always understood the moment where Stephen picks at the louse to be a pretty straightforward reference to the family's poverty, but you're right to point out that it's closely connected to him private thoughts about Emma, and his qualms about the potential inappropriateness of those thoughts. He may have "freed" himself from the church, but the idea of sin still plays a huge role in his psychological life--as Cranly says, his mind is "supersaturated" with the religion he claims to disbelieve. And therefore women (and girls) to him all fall either into a holy/sacred category (the BVM, Emma, the "bird girl" on the beach) or the whore category (the women he encounters in his own mind, and in his visits to the brothels). He seems incapable of bridging the two, and this has a lot to do with his tendency to keep Emma at a distance (and then brood over that distance incessantly!).
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