By Andrea Sachs

Until recently, preteen Emma (a pseudonym) lived in a bustling two-career home on the Upper West Side. But an additional, unwanted job has overtaken her parents’ already busy lives. Emma, an elementary school student, contracted head lice last month for the third time in two years, and it quickly became the main concern of her family yet again.

Emma is a textbook example of the child most likely to get Pediculous humanus capitis, better known to its unhappy victims as the head louse. According to “The No-Panic Guide to Head Lice Treatment,” published by the Johns Hopkins Medicine website, lice are most common in girls, children between the ages of 3 and 11, and those who are Caucasian. Another possible contributing risk factor for Emma: Head lice are more plentiful in metropolitan areas.

Emma has plenty to say about what it’s like to have lice on your scalp. “It’s really itchy and it feels like there are bumps on your head,” she says. “You start feeling like your head is going bald. You feel like you’re itching all over. Sometimes you can even see the lice, and it’s really disgusting.”

When lice strike, Emma’s family collectively takes action. “The lice shampoo that you use, my dad globs it on my head, and mushes it around. And then I wash it off. Usually it works, but right afterwards, my mom combs through it with a special lice comb and she usually gets the remains of it.” Then her parents throw her sheets and pillowcases in the washing machine. “We’ve become lice hypochondriacs,” says Emma’s father. “If you miss just one, it will slowly reproduce and reinfect.”

As of a week ago, the family’s efforts succeeded, and Emma is now in the clear. She has a tween’s self-consciousness about the whole 10-day crisis. “I feel like if anyone noticed the lice, they would feel uncomfortable, and I would understand.” The experience was wearing on the whole family. Says Emma, “Since I had lice for so long without it going away, my parents were thinking of sending me to get it professionally removed.”

Lice are a perennial problem for school-age children, and it’s impossible to gauge whether their incidence is on the increase on the UWS this year. Calls made to city and state health agencies yielded no current statistics. And at the national level, the Centers for Disease Control and Prevention offer data almost laughable in their inexactitude: The agency reports that an estimated “6 million to 12 million” infestations occur each year in the United States among 3- to 11-year-olds.

What can be gauged is this: in the last decade or so, an industry has grown up in response to the problem, including businesses that will come to your UWS home for discreet consultation and removal of lice and nits (their eggs).

The rise of mobile louse removal services may have been inevitable: where some people see misery, others see money. According to Global Market Insights, a market research and management consulting company, “The North American lice treatment market accounted for $461.5 million market revenue,” and is anticipated to grow 6.4% by 2032 – including everything from sales of special shampoos to the at-home lice removal services.

Perhaps because no one really wants to think about the realities of a head-lice infestation, the lice removal companies that service the UWS operate under catchy names like Lice Happens and Larger Than Lice. These companies are pricey, typically running hundreds of dollars per visit, depending on the number of family members and the severity of the problem. But many parents are at nit’s end and willing to pay almost anything to solve the problem. These outfits offer their services almost around the clock, some available from 7 a.m. to midnight, 365 days a year. And most appealing to many parents, because they visit you at home, there is no need for your nosy neighbors to know the nitty gritty of your life. (Okay, I’ll stop with the parasite puns.)

In fact, the lice removal industry is notable for its devotion to secrecy. Although medical authorities and school officials in NYC and elsewhere have repeatedly told the public that lice are not the result of bad cleanliness habits, a sense of embarrassment, if not shame, often follows this condition.

“If a child is upset,” says Lena Gorelik, the founder and owner of Lice Free Noggins, “you calmly explain that [having lice] is normal. That it happens to everybody, and that it’s very easy to take care of. It doesn’t mean that you’re dirty or doing something wrong. You always want to make sure that the child is comfortable.”

Gorelik, whose company was founded in 2013 and now makes house calls citywide, has helped hundreds of families on the UWS; in addition, she said she regularly goes into both public and private UWS schools to check students for lice.

Then there is Derek Croft, a former management consultant who last December purchased LiceDoctors, a 15-year-old New York lice treatment service. Croft lives in Dallas, but his at-home treatment company works nationwide, including on the UWS.  Technicians come to your home in unmarked cars, says Croft. “There’s a lot of stigma around lice, even though there shouldn’t be. Because of that, our technicians are very discreet,” he says. “Your neighbors don’t have to know—that’s the idea.”

Croft says that his technicians tend to be former nurses, teachers or hairdressers. “They come into a situation in homes where the situation is often very stressful” so they “will bring toys or stickers to play with. For the child, it feels like someone is just combing their hair, which can feel very relaxing to them. Sometimes, it’s more of a struggle.”

For UWS parents who decide to eschew paid services, there is good news. There are many excellent websites online, like those of the Mayo Clinic and CDC, which will help school you in the fine art of nitpicking.

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