Helen Hadley pulls a lamp closer to the head of a 7-year-old girl who, for a lice check, is sitting on a tall chair in Hadley’s kitchen.
She's looking at dead lice attached to a piece of tape that the girl's mother brought in. "They sure are different in shape, fatter than they usually are," Hadley says. Then she looks at a tiny brown speck. "Yeah, that’s definitely a nit, so I’m going to assume those are extra large-sized insects. Maybe it’s a new variety."
Hadley is known to her clients as The Nit-Picker, a self-trained de-louser. She got her start when she and her daughter had lice that wouldn’t go away. Now she travels to people’s homes in her unmarked car to take care of infestations.
The family receiving a de-lousing on this day doesn't want to be named or even identified by town because of the stigma that lice still carry. The girl’s mother has already pulled out several dead bugs and eggs — or nits — but she’s is paying The Nit-Picker $100 an hour for peace of mind.
"(It gives me) reassurance just to make sure I got it all," the mother says. "And I don’t want to leave any stone unturned."
Hadley says her business has been steadily growing since 2001. "It seems that the products that might’ve once worked fairly well are not working very well at all," she says. She adds that families are being instructed by a physician to use over-the-counter shampoos and finding they still have live bugs.
But just because the nit-picker’s business is growing doesn’t mean there’s a growth in the occurrence of lice. Head lice cases are hard to quantify because most pediatricians won’t deal with it, school nurses don’t keep track of it, and no one is required to report it to public health departments because lice don’t carry infectious diseases. Public health experts estimate that one in 100 kids is infested.
“It’s unlikely, honestly, that head lice is passed at school because students are not in that intimate head-to-head contact.”Kate Donnelly, Brookline School Health Services
"Head lice do not impart any advantage, but neither do they serve as a measurable threat to the infested child or to anybody else," says Richard Pollack, who has a PhD in parasitology and until recently worked at the Harvard School of Public Health.
Pollack says lice are becoming more of a headache for two reasons: Parents don’t follow the full instructions on the treatment shampoo to get out all the nits and re-apply 10 days later. And, as we use more toxins to kill lice, the bugs are getting more resistant. But Pollack insists that’s not a big deal because a prescription insecticide will kill resistant bugs and removal by hand always works. The only burden, Pollack says, is hysteria from parents and some school officials. Most kids don’t even know they have lice.
"They are at peace with their lice," Pollack says. "The lice don’t bother them, they don’t bother the lice, what could be better?"
No lice would be better, most parents would say. Lice don’t jump and they don’t fly. They are transmitted by head-to-head contact, which kids get a lot of, especially at sleepovers, says Kate Donnelly, the coordinator of school health services in Brookline. She says lice is a year-round problem that seems to surge in the fall when kids return from camp.
"I think we probably see more of it in September because students are sleeping together away at camp, so they're passing it along," she says. "It's unlikely, honestly, that head lice is passed at school because students are not in that intimate head-to-head contact."
But it's schools that send home the dreaded letter that says "someone in your child’s class has lice." Many school systems, including Brookline’s and Boston’s, have stopped sending kids with nits or lice home from school because it’s not medically serious. Even though the American Academy of Pediatrics discourages excluding kids from school for nits, Donnelly says many parents want to, anyway.
"For many, many years there were no-nit policies, and there's a lot of pressure for school systems to continue to have that," she says. "You know, nobody wants their child to have little critters in their head."
Back in The Nit-Picker's kitchen, the lice aren’t bothering the 7-year-old who is sitting patiently, eating candy while Hadley goes through her hair, almost strand-by-strand.
Her mother says this is the second time she's come to a professional. The first time her daughter had a horse bug, not lice. Lice is often misdiagnosed. This day the older daughter, who had horse bugs, is also getting a check because she’s about to go to sleep-away camp.
Many camps are telling parents to check their kids for lice before they come and stay home if they have it. That’s helping to keep the nit-picker and other private head pickers in business.
Hadley shows what a nit looks like. "It’s a tiny little, almost vaguely iridescent and microscopic little thing attached to the side of the hair shaft," she says.
Maybe with the newly sequenced body louse genome, a better treatment for head lice isn’t far away. Until then, is your head itching yet?
This program aired on June 25, 2010.