Mary Collar took a break from running her busy salon this week to tell me about a client who’d arrived exasperated and desperate for her services.

It wasn’t a woman with a bad dye job. Or a guy sporting a haircut gone wrong.

It was a kid — with lice.

A head lice infestation among Mary Collar’s family prompted her to start a Waterville lice-removal business. Jim Evans | Special to the BDN | File photo

Collar operates All About Lice, a lice-removal service in Waterville that she opened in January 2015 after 11 members of her family got lice and spent hundreds of dollars on chemical treatments. The business, set up as a child-friendly salon, will have served 1,000 customers by the end of this year, she estimates.

“My phone has been ringing,” Collar said.

Demand for services like hers has risen along with the proliferation of so-called “super lice,” which have grown resistant to the usual treatments.

All About Lice is now among about half a dozen businesses specializing in lice removal in Maine, including others that offer in-home treatment. Among them are NitsEnd, Do it Right DeLousing, and, because why not, Desperate Lousewives.

A 2015 analysis found that Maine was among 25 states where lice have become resistant to ingredients in over-the-counter treatments. Lead researcher Kyong Yoon, an assistant professor at Southern Illinois University, subsequently found treatment-resistant genes in more than 98 percent of lice samples his team collected in 48 states. The Journal of Medical Entomology published his findings in May 2016.

This problem has been a long time coming, with related studies dating back more than two decades.

The first line of defense against head lice are insecticides known as pyrethrins, botanical treatments derived from the chrysanthemum flower, and their synthetic cousin pyrethroids. These are the active ingredients in many drugstore lice treatments, including Nix and Rid brands.

After decades of exposure, lice have genetically mutated to become desensitized to the insecticides, the research shows.

“Almost everyone that comes in here has already tried one of those products,” Collar said.

Mary Collar with her granddaughter Emma Copeland. Jim Evans | Special to the BDN | File photo

Head lice are mostly harmless and aren’t known to transmit disease. But the little parasites cause itching as they feast on our blood and deposit their eggs (called nits) at the base of hair shafts. Lice can’t jump or fly — they spread by crawling from the hair of an infested person to others.

The U.S. CDC estimates that 6 million to 12 million head lice infestations occur each year in the United States among children aged 3 to 11.

Collar’s anecdotal estimate is a bit more alarming.

“There’s lice in every single classroom,” she said. [Parents] need to count on it.” 

The American Academy of Pediatrics recommends that parents first try over-the counter treatments. If those don’t work, particularly in areas with known resistance to the products, parents should call their child’s doctor about trying a prescription medication containing newer-generation chemicals, such as benzyl alcohol and ivermectin, the academy recommends.

(Yoon’s research was partially funded by Sanofi, a drug company that sells a lice treatment product containing ivermectin.)

Some of the prescription medications work, but they’re harsh on the hair and scalp, Collar said. She uses a non-pesticide product and special comb to remove lice and nits, charging $150 for an hour-long treatment, products to take home, and follow-up visits.

Dr. Laura Blaisdell, a Yarmouth pediatrician, said she’s had success with another approach. Parents can apply the gentle facial cleanser Cetaphil to their child’s hair to smother lice, comb it out, and then heat the base of the hair follicles with a hair dryer to kill any lingering eggs. The method avoids the application of chemicals, and if repeated every 10 days for several cycles, seems to do the trick, she said.

Over-the-counter treatments kill adult lice, but they’re not 100 percent effective at snuffing out the eggs, Blaisdell said. That’s why combing the hair to manually remove nits is so critical, a delicate and time-consuming process where parents often fall short, she said.

Head lice on a strand of hair. Jim Evans | Special to the BDN

Leaving even one tiny egg behind can keep an infestation alive. Ten days later it will hatch and begin laying its own eggs — up to 30 a day, Blaisdell said.

“Missing that one little egg that remains alive that can wreak havoc for families for months,” she said.

Doctors also stress that personal hygiene and cleanliness play no role in head lice infestations.

“It’s probably a combination of the type of hair you have and bad luck,” Blaisdell said.

If your kid gets lice, don’t bother scrubbing your house from top to bottom either. The AAP doesn’t encourage excessive cleaning to deal with a lice infestation, as the bugs die within 24 hours after falling off their host. But parents should wash pillow cases and other items that come in contact with the hair of anyone with lice.

Collar suggests buying a high-quality lice comb and using it on kids’ hair regularly, even absent symptoms of lice.

“After a sleepover, or dance class,” she said. “They can get lice anywhere.”