Last year, an Anchorage mother named Danni Hall found herself crying in the aisle of a Walgreens.
Her two daughters had picked up head lice at their elementary school, which had seen an infestation so severe that every girl in one kindergarten class had gotten it.
For weeks, she had been fighting the bugs with $200 worth of shampoo treatments, only for the lice to reappear.
In tears, Hall called her sister in Washington state.
"She said, 'Why don't you take her to one of those places?' " she said. "And I was like, 'What places?' "
Hall learned that in the Lower 48, parents have the option of taking their children to lice-removal clinics, some with quirky names like Lice Busters, where they can pay a fee to have lice removed by a trained technician.
She knew enough parents in Anchorage dealing with lice to think this could be a business.
"I just saw a huge need," said Hall.
So in January, Hall opened The Alaska Lice Clinic, which she said is the first facility in the state dedicated to the art of delousing. In doing so, she became part of a tiny but growing industry of professional lice removers, a phenomenon well-established in the Lower 48 but relatively new to Alaska.
While public health experts say lice are more nuisance than danger, they are a chronic and stressful problem for schoolchildren in Anchorage and beyond.
Experts say anyone can get lice and it has nothing to do with socioeconomic status or cleanliness. But money and time dictate how families treat it.
An unpleasant fact of life
Lice have long been an unpleasant fact of life in schools everywhere, said Emelyn Hudson, the Anchorage School District's health care services coordinator.
So far this school year, 421 students have been diagnosed with live lice by school nurses, according to the district. Some have had recurring infestations. That number doesn't reflect children whose parents have diagnosed them at home.
Are more children getting lice? That's hard to say, said Hudson. The previous year's diagnosis data was not available. Lice can spread quickly in a classroom or school through kids coming in close contact with one another.
Some parents don't like the school district's policy of allowing students found to have nits — the eggs, not the live lice — to stay in class, Hudson said. A few years ago, about 100 parents even signed an online petition asking the district to change its policy, saying it allowed lice to spread. But Hudson says ASD is in line with other districts in the country and follows the American Academy of Pediatrics' recommendations.
Some researchers think lice have become resistant to common over-the-counter eradication methods, and these "super lice" are harder to get rid of for good.
School nurses say a case of lice can push stressed families over the edge: Children with live lice have to stay home from school, meaning parents have to stay home from work.
Sometimes parents cry when told that their child has lice, said Kathy Bell, a nurse who has been with the district since 1985.
"It's overwhelming for parents," said Bell, a nurse at Goldenview Middle School. "They have so much to do already."
A persistent myth that lice are a sign of uncleanliness means parents often feel compelled to deal with the problem in secret, said Wendy Williams, a nurse at Chinook Elementary School in South Anchorage. That stigma is not rooted in fact, Williams said: Lice actually prefer to cling to clean hair. Still, nurses keep it a "personal and private" matter to avoid embarrassing students.
This has been a rough year for lice at her school. Williams said she's found lice on at least a dozen kids since December, some with recurring infestations.
Treating lice effectively can be expensive and time-consuming, Williams said. It requires nightly checks. Some treatments cost $20 or $30 a box.
"It's three weeks of it. It takes time and diligence."
At her Title I school, many parents are busy working one or more jobs and don't have much money, Williams said. They try their best to help but some rely on do-it-yourself treatments like Listerine, rubbing alcohol and mayonnaise, Williams said. The professional lice-removing services say some insurance will cover their services, but not always.
In the past, Williams has been able to keep boxes of over-the-counter treatments in her office. This year there's no money for that, she said. She's spent hours picking lice out of her students' hair one by one, taping them to paper to show parents.
Hall's Alaska Lice Clinic is tucked away in a tiny but sleek medical suite on the Alaska Regional Hospital campus.
Hall, a former flight attendant and real estate agent who had been a stay-at-home mom for years when she opened the clinic, originally wanted to locate it in a strip mall, but almost a dozen landlords turned her down. Some wanted her to take the word "lice" out of the name.
Her method, learned at a Nashville nonprofit, is time-intensive. On a recent morning, an 8-year-old client gazed at her mother's phone while Hall divided the girl's hair into small sections, combing through each one strand by strand with a small metal comb. When she found a nit or a live louse, she discarded it into a bowl of water. A full head takes two to three hours, Hall said. She charges a flat rate of $250. Last weekend she was up late treating a family of six; the mother had told her, "Money is no object."
The people who contact her tend to sound desperate, she said. One mother and child traveled from Kodiak to be treated. A woman living off the grid in the Susitna Valley came in. She told Hall that she'd tried putting kerosene on her hair, an old and dangerous method that Hall strongly advises against.
Hall's isn't the only business that serves Anchorage's delousing needs. LiceDoctors, a New Jersey-based national chain that specializes in house calls, has been operating in Alaska for about three years, said owner Karen Sokoloff.
The company doesn't have a storefront but promises that its technicians will show up at clients' doors in an "unmarked car."
Business is brisk: The company has three technicians working in the Anchorage and Mat-Su areas, more than Sokoloff thought would be needed.
"There's sure more business than I thought there would be," she said.
Back at The Alaska Lice Clinic, Hall turned on a video for her client. The girl's mother was next up. Another little secret of the lice world Hall has discovered: When a kid gets it, a parent almost always does too.