CORAL GABLES, Fla. — The 7-year-old girl bounces in her chair as the technician slides a fine metal comb through her wet hair.
"It's like a spa day," Ayla Marchante said. "I don't even have to go to school!"
Ayla and her twin sister, Alli, aren't at a high-end spa or hair salon. They're at Lice Troopers, a lice clinic in Coral Gables that specializes in all-natural lice removal treatments.
"The joy of being 7, " said Barbara Marchante, the twins' mother.
The Marchantes are but one of dozens of patients the lice treatment franchise sees daily across its four locations in South Florida. According to Lice Troopers CEO and founder, Arie Harel, the back-to-school season has always been the busiest because students return from summer camps.
By 10:30 a.m. Monday, the clinic's schedule was nearly 80 percent full for the day, and by 5 p.m., the lines were out the door. Lice Troopers, which opened in 2014, has locations in the Gables, Kendall, Bay Harbor and Hollywood, Fla. It's also opening clinics in Doral and Pembroke Pines.
Harel attributes the growth in business to two things: immunity to chemical treatments and selfies.
"Everybody has a phone, and they're all taking selfie pictures," he said. "So head lice is spreading at so much of a rapid pace now than ever before."
Where Harel used to see elementary-aged children in his clinics, he now sees kids up to 16.
According to the Centers for Disease Control and Prevention, an estimated 6 million to 12 million infestations occur each year in the United States among children 3 to 11.
Lice are white, sesame seed-sized parasites that attach themselves to hair and feed on blood. They can live on hair found on the head, body and in the pubic area. If allowed to reproduce, a proliferation of lice will cause an itching sensation that can only be stopped once the lice and their eggs — called nits — are removed.
Lice can't fly or jump, and head lice isn't caused by poor hygiene. It can only be transmitted by direct contact with the hair of an infested person, said the CDC.
The Florida Health Department doesn't keep track of lice cases. But Daisy Diego-Gonzalez, a Miami-Dade county public schools spokesperson, said September usually is too early to see an uptick in lice cases. The spike usually increases when the hats and jackets come out in the cooler months. So far, very few cases have been reported, she said.
However, Dr. Aileen Marty, a Florida International University professor of infectious diseases and practicing physician, said a spike in cases often do occur during the back-to-school season.
Summer camps, she said, are a "wonderful source of lice."
According to Marty, lice with immunity to treatments — called super lice — are fueling the problem. "Resistance is a real issue. The resistance is absolutely true," she said.
Physicians have started to turn to more powerful and toxic pesticides like lindane, malathion and carbaryl. But even these are losing their effectiveness as well due to resistence, she said.
Lice-combing businesses aren't regulated by the state of Florida and lice technicians don't have state permits, but technicians at Lice Troopers are sent to the company's training centers for about six weeks before working in the field.
When Hodelys Barcelo discovered her daughter, Alyssa, had lice, she went straight to the clinic.
The mom said the Lice Troopers lice-free guarantee was a huge incentive to bring her daughter in.
"I wanted to make sure that whatever treatment we did, we'd be free of the problem," she said.
Hodelys said she didn't want to spend money on over-the-counter treatments that may not work. She also didn't want to risk bringing an even greater infestation to her house through at-home treatments.
"[Lice is] nothing to be ashamed of," Hodelys said. "It's not because your dirty. It happens to the cleanest of people."