Cleaning up with lice treatments

Concerns about toxins fuel alternate approaches

At NitWits’ Cambridge office, Lisa Esparza worked on a 5-year-old who had lice earlier this month. At NitWits’ Cambridge office, Lisa Esparza worked on a 5-year-old who had lice earlier this month. (Essdras M Suarez/Globe Staff)
By Jenifer B. McKim
Globe Staff / May 27, 2011

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Creepy and gross. That’s how some people might describe Berit Pratt’s business. And no wonder. Her five professional nitpickers spend their days combing tiny blood-sucking lice and nits — bugs’ egg sacks — from people’s heads, earning about $200 for each scalp they delouse.

It’s a price more people, usually panicked parents, are willing to pay. Pratt, 56, said her Cambridge company, NitWits, has doubled its number of clients over the past year.

She says she has come to understand the insects that once terrified her as a school nurse. “You have to have some kind of tolerance for the yuck factor,’’ said Pratt, whose company treats about six heads a day.

NitWits is one of an increasing number of area companies that specialize in offering nontoxic treatments for head lice. They have quirky names like Lice Aunties and Desperate Lousewives, and charge hefty fees — about $100 an hour — for house calls or camp visits. Their popularity is being spurred by health-conscious parents who are shunning traditional treatments — including dousing children with chemicals — and turning to alternatives that usually involve the manual removal of lice and nits.

The Centers for Disease Control and Prevention estimates that between 6 million and 12 million children ages 3 to 11 suffer from lice. The problem may be getting worse, health specialists say, because the parasitic insects have become resistant to certain over-the-counter chemical-laced shampoos recommended by the American Academy of Pediatrics and other health agencies.

“Some of the products that worked in the past are not as effective,’’ said William Brogdon, a research entomologist with the CDC.

The wingless bugs aren’t known to carry diseases that affect humans, but their saliva and feces can cause itching, according to the Massachusetts Department of Public Health. Lice can’t fly or jump and are spread from head to head mostly through direct contact, likely to affect children who spend time in close contact. They live only a day or two off a human scalp, according to the CDC.

Public health concerns about chemical treatments to kill lice have been around for decades. The Newton-based National Pediculosis Association (pediculosis is the scientific word for lice infestation) was launched in 1983 to protect children from the “misuse and abuse of potentially harmful’’ chemical-laced treatments.

In 2009, the Food and Drug Administration warned that shampoos made with the chemical Lindane can cause seizures and even death, especially among children and babies. Despite the concerns, prescription-only treatments containing Lindane remain available in most of the country. The FDA says the treatments should be used only when other products are ineffective.

The state Department of Public Health still recommends medicated shampoos, including those with Lindane, but warns that they “may be toxic and should be used with care.’’

Along with nit-picking, small businesses that shun drug treatments for lice offer other products and services, including combs and nontoxic shampoos.

Julie Blumenthal, owner of Lice Aunties in Newton, uses a device called the LouseBuster. The contraption — similar to a sophisticated hair dryer — kills lice and eggs with heated air, and was invented by a University of Utah scientist.

Others, like the owners of Desperate Lousewives in Stoneham, have flown to West Palm Beach, Fla., to complete a course in “strand-by-strand nit removal’’ offered by the nonprofit Lice Solutions Resource Network Inc. The group says it has certified more than 40 businesses around the country, including two in the Boston area.

In Connecticut, the six-year-old Lice Treatment Center sells “all-natural, nontoxic lice treatment’’ products online. The company, co-owned by a pediatrician, has about 20 employees in the Boston area who make home, school, and camp visits.

“People are very much against using chemicals on their kids these days, and they don’t work,’’ said co-owner Elizabeth Solovay. “Our volume has grown consistently, really exponentially.’’

But some worry that the unregulated industry may pose its own health risks.

Richard J. Pollack, a research associate at the Harvard School of Public Health, worries about unlicensed practitioners going into homes and diagnosing the existence of lice. Pollack believes the number of lice infestations is grossly exaggerated because people mistake a spec of dust, dandruff, or a random fly for a louse.

And Pollack remains confident in over-the-counter and prescription treatments because there so much data are available about their safety and efficacy. Adverse health effects from such products are “trivial unless you are an insect,’’ he said.

“These [alternative] salons are popping up with such frequency it seems they are spreading faster than the lice themselves.’’ said Pollack, who founded a Needham company, IdentifyUS, which identifies insects.

Deborah Altschuler, president of the National Pediculosis Association — which sells a $9.95 metal comb for fighting lice — shares Pollack’s concerns about the proliferation of lice-treatment companies.

“It’s overwhelming,’’ Altschuler said. “There’s no accountability for opening a business.’’

But there certainly is a demand for their services.

“The money is out there,’’ said NitWits’s Pratt. After parents have exhausted the standard options for treating lice, she said, “They are willing to give us their firstborn.’’

Jenifer B. McKim can be reached at