A Blog from Your Kaiser Permanente Pediatricians in Northern California

Happy Mother’s Day – I’ve Got Lice!

Picture this: It was 6:30 a.m. on Mother’s Day, 2010, when my dear daughter climbed into bed with me to read a book. I decided to give up on the dream of sleeping in and give into the joy of her love! Then, as I snuggled in with a nuzzle of the top of her sweet head, I found – argh – lice nits! What a way to start the day, any day, let alone Mother’s Day.

So I did what most mothers would do – jumped up and went into panic/action mode. I spent my Mother’s Day washing, picking nits, combing, doing laundry, vacuuming, and cleaning.

The tiny grey bugs called head lice lay even tinier white eggs (nits) on hair shafts, causing distress way out of proportion to their size! Many a panicked parent calls their pediatrician or heads to their office asking for help with this common problem (there are millions of lice infestations each year in the United States).

But let’s see if we can save you from panic or a trip to the doctor.

The most important myth to be debunked: Lice don’t spread disease or cause illness. They’re also not a sign of uncleanliness!

Some bug facts:

  • Adult female lice lay about 10 eggs a day. These nits hatch into lice in about 1 week.
  • Nits can’t survive more than 2 weeks off a human scalp and can’t hatch at temperatures lower than the human body’s.
  • Adult lice survive 3 to 4 weeks on the scalp and less than 24 hours off the scalp.
  • Lice crawl. They can’t hop or fly. Usually you get infested from direct contact with the head of an infected person, and rarely from using that person’s belongings, such as hats, combs, and brushes.

It’s uncommon to get lice from sharing sports gear, and a child should never be asked to not wear protective head gear (like batting helmets) for fear of getting lice.

I bet you’re scratching your head now!

How to know if your child has lice: If your child has an itchy scalp, check their scalp carefully. Here’s what to look for:

  • Lice are about the size of a sesame seed, gray-colored, move quickly and avoid light, making them difficult to see.
  • Nits are whitish eggs attached to hair shafts near the scalp in numerous quantities. It’s usually quite easy to see them! However, sometimes people mistake nits for dandruff or lint. You can tell the difference by trying to shake or flick them off – eggs stay stuck to the hair.

How to treat lice: The key here is to very carefully comb out the nits from tiny sections of hair after using an over-the-counter (OTC) medicated shampoo or cream.

I sat my daughter on a high stool under a bright light and we talked while I combed and combed. Surprisingly, this became a nice time to bond and connect! After the nit combing, it helps to use a hairdryer to thoroughly dry each section of hair. For more treatment advice, see our page on lice.

In some communities, lice are resistant to OTC medicines and you may need to call for a prescription treatment.

Don’t go overboard with cleaning! Remember lice can only live 24 hours off the scalp, and nits are unlikely to hatch at room temperatures. So follow a few tips for cleaning, but don’t exhaust yourself:

  • Wash and dry bedding, towels, clothing, and hair care items at a high temperature.
  • Vacuum furniture, carpeting, and car seats.
  • Put things that can’t be washed into plastic bags for 2 weeks.
  • Avoid pesticides in your home; there’s no need to use them.

After treatment, your child should return to school.The American Academy of Pediatrics doesn’t support school “no nits” policies. No child should miss valuable school time once the lice have been treated.

There’s no doubt – lice are seriously icky! However, they don’t carry disease and are harmless to your child. This makes it very important that the treatments for lice are safe and your reaction to the lice is as calm as possible.

Reassure your child that lice won’t hurt them, and they didn’t get lice because they were dirty or the house was unclean.

My Mother’s Day 2010 ended with a very clean house, 3 slightly traumatized children, and 1 exhausted mother. Next time we have lice – and there will likely be a next time – I hope to be able to respond more calmly.

Find additional resources for parents:

My Doctor Online:
Get Rid of Head Lice

American Academy of Pediatrics:
Head Lice: What Parents Need to Know

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