Nancy Harris will never forget the horror of that Christmas two years ago.
While the family was opening gifts, her then-7-year-old daughter was scratching her neck. Harris parted Emily's thick, long locks and found a full-blown infestation of lice.
"It was disgusting. Awful. Awful," said Harris, 49, who lives in Wayne. That morning, she spent three hours picking out the bugs - 18 live ones.
That's why, when Harris recently heard about an outbreak at Emily's school, in the neighborhood, and at the family's church, she swiftly dialed Lice Happens - a new mobile lice-removal service.
This time, her child would be screened by Emily Betterly, a pro, and when she received that clean bill of hair, well, Harris knew she could trust it. "It was well worth it," she said of the half-hour, $50 visit.
Lice Happens of Plymouth Meeting is one of the newest nitpickers-for-hire to join an expanding industry that includes Lice and Nit Removal Services in Chester and Family Lice Removal in Highland Park, N.J., which covers the Philadelphia area.
Adept lice-spotters equipped with magnifying gear, fine-tooth combs, and delousing concoctions are relieving parents of the tedious (and let's be honest, gross) job of ridding children of the creepy-crawlies - starting at $100 an hour.
"It can happen to anyone, anywhere," said Gordine Miller of Lice and Nit Removal Services, which has been open about a year and charges $175 a head.
"Someone called me last night at 10:30 p.m. She said, 'Please. I have bugs. They're driving me crazy.' "
The head louse, smaller than a sesame seed, is a parasitic insect that lives close to the scalp and feeds on human blood. Each year, an estimated 6 million to 12 million infestations occur in the United States among children 3 to 11 years old, according to the Centers for Disease Control and Prevention.
Treatments include over-the-counter and prescription hair products that contain insecticides to kill the adult lice. But the bugs are tough to fight. Experts say they are becoming resistant to the established medications. And some researchers are concerned about neurological effects of the chemicals.
Besides, even if the shampoos exterminate the adult lice, only a really thorough comb-out gets rid of the eggs. Miss a few nits and the cycle starts all over again.
"You have to go through every strand of hair," Miller said. "You cannot shortcut this job."
That takes patience and inevitably causes frustration. Many districts have no-nit policies, meaning children cannot return to school until they are free of the microscopic, brownish eggs.
In this time-strapped age of two working parents, most mothers (the task usually falls to them) would rather do just about anything than stay home and comb.
So of course, it was only a matter of time before on-the-go nitpickers, often with catchy names like NitWits or Hair Whisperers, emerged. Although it's hard to track the exact number of bug fighters out there - no license or credential is required to open this kind of business - a lice education association says their ranks are proliferating.
"Every other day there's another one of these," said Deborah Altschuler, president of the National Pediculosis Association, a nonprofit in Newton, Mass.
She welcomed an option that focuses on combing out lice rather than using insecticide treatments, which the organization opposes.
But Altschuler also voiced concerns. "Who are these people?" she asked. "There needs to be some regulation."
Betterly, who opened Lice Happens in March, was an environmental scientist turned stay-at-home mom. Then her college roommate, M.J. Eckert, joined a neighbor in Annapolis, Md., to open Lice Happens early this year. Betterly was asked to join but passed.
The next day, her daughter, Victoria, 9 now, got lice, and an alarmed Betterly raced the girl to Annapolis.
Eckert, a nurse, handed her friend the lice comb and said: "She's your first client."
Since then, Betterly has combed more than 400 customers.
"You go to a cocktail party and people ask, 'What do you do?' " Betterly said. When she tells them, they often step back before saying "Ewww!"
Even husband Chris, 52, supportive of the venture, was wary when Betterly brought home plastic bags of picked lice. True, they were dead, but "I could just picture vermin all over the place," he said. He insisted she keep her tools outside the house and not use the pot in which she boils the combs for anything else.
"There is still horrible stigma," Betterly said. Lice are assumed to signal poor hygiene. In reality, the insects prefer clean hair, she said.
House calls allow for discretion. Still, one Main Line client walked Betterly out and down the long driveway - then sighed in relief. Thankfully, Betterly's Volvo wagon didn't have a big sign.
For one Coatesville family of four, the combing service was a godsend, a last attempt to rid themselves of bugs - and the stigma - that have plagued them for five years. Of course, if they were outed in a newspaper article about lice, the benefits of a discreet visit would likely be eliminated. So they asked that only their first names be used.
Tricia, 37, thinks she contracted the parasites from the hospital where her son was born in 2004. Soon lice had spread to the boy, her 8-year-old daughter, and her husband, Don.
"It's been such a trial," Don, 41, said.
The family tried over-the-counter remedies repeatedly. Prescriptions. And natural recipes from olive oil and alcohol to mayonnaise.
"None of it worked," Tricia said.
"I thought a swimming pool of chlorine would do it," Don added. "It didn't."
"We're to the point where we kid about it," she said. "I say, we'll just name them and keep them as pets."
Over the years, the itching would wax and wane. Last summer, the children's condition was spotted in church camp and they were sent home. The church offered to pay the $600 tab for a combing service because Don, a rural postal carrier, and Tricia, a stay-at-home mother, could not afford it.
On a Tuesday evening, Betterly, 49, dons a blue, plastic apron and serious-looking black goggles that magnify 2.3 times.
"We're going to become very friendly," she says. Betterly stands over Tricia in the brightly lit kitchen and divides the woman's hair into two-inch-wide sections, then swipes - down, under, and both sides - each bundle with a very fine-toothed metal comb. After every rake, she wipes the tool on a white paper towel. "The whole key to this success is redundancy."
In minutes, Betterly finds a live louse. Out come the tweezers, and the speck is dispatched with a crunch. For nearly two hours, Betterly combs, and combs again. She also sprays a pesticide-free enzyme solution. Only several nits are found.
Five-and-a-half hours later, the family is louse-free, Betterly says confidently. The daughter had the worst case with nearly three dozen adults and many more nits. In what Betterly calls the "crunchy game," the child got to crush her own lice.
This topic has a way of making folks itch. Betterly, though, never feels the urge.
"Lice do not fly and do not jump," she said. As long as she avoids head-to-head contact, she's safe - a fact that makes the job palatable, she said. "I have never gotten lice, ever."
While most may not be able to get beyond the ick factor of the work, Betterly said she focuses on the rewards. "Often, families are freaking out," she said of urgent phone calls at all hours several times a week. "They are so upset.
"You come in and put them back to normal life," she said. "Half the time, people hug me when I leave."