• by Les Luchter , Staff Writer, Yesterday

Why launch a new consumer health company with a lice removal product, of all things?

When Cartwheel Founder-CEO Joanna Shu’s own kids got head lice, and she went shopping for treatments, “the options on the shelves all contained synthetic ingredients or a pesticide base,” she explains to Pharma & Health Insider.

So the entrepreneur, who had previously developed 17 natural beauty products as founder-CEO of Refresh Skin Therapy -- which similarly arose out of her own experience with skin allergies -- set out to find an alternative.

The first plan was to develop a medical device for doctors’ offices that would use CO2 gas to kill lice, she recalls, but “we quickly realized the price point of that made it pretty inaccessible for most families.” As a result, when “a retired investor came to us with a clean formula, we saw that we could get this to market much faster than a medical device with a winky FDA path. This could be on the shelf with a price point that most families could afford, so we ran with it.”

The strategy seems to be working, as Cartwheel’s lice product, which launched online today, has already landed a deal to be in 6,000 Walgreens stores nationwide starting March 16.

That came about because it's a natural product, Shu says, while competitors -- led by Prestige Consumer Health’s 40-year-old Nix -- often include permethrin. It’s an insecticide that’s "a known neurotoxin,” Shu says, admitting that while it wouldn't cause neurological damage at the levels found in lice treatments, “a lot of parents just don't want to take that risk.”

Cartwheel’s product, on the other hand, combines coconut oil, mild cosmetic abrasives, and limonene derived from orange peels said to kill lice and nits when combined with gentle brushing. A metal comb, applicator brush and gloves are also included in the package.

Cartwheels’ marketing approach to lice, Shu says, emphasizes using “a lot of humor to destigmatize it” -- starting with the product name, Nit Happens. It includes a mascot character, a friendly lice-like cartoonish character named Professor Harry, who’s found both on the Nit Happens packaging and in educational materials.

“We use a lot of friendly language," Shu adds. “We’re talking to moms who are probably scared because there’s bugs crawling on their children. Viscerally, it's gross.”

So, Cartwheel assures them, “You didn’t sign up for lice – but we did.”

While the main user base for Nit Happens is parents in their 30s with kids aged three to 11 -- “usually moms making home healthcare decisions” -- they’re not whom Cartwheel is targeting in its outreach.

Instead, school nurses are in the bullseye, through such tactics as sampling at their trade shows, and distribution of samples, print and digital materials, posters, and coupons in both English and Spanish.  Cartwheel is also sponsoring the “Bluebonnet Awards” for excellence in school nursing, which is currently in a Texas-only test.

“They're in the trenches,” Shu says of the nurses. “Usually, a child is diagnosed at school. They’ll be scratching their head in class. They get sent to the nurse. We want the nurse to say, ‘we’ve got a sample or a coupon of this product.’  School nurses not only have budgets to purchase, they are big-time recommenders. And nurses are probably one of the most highly trusted people in our society, even more than doctors.”

Parents, on the other hand, often misdiagnose the problem. 

She cites herself as an example. “I was totally guilty. It’s my job, and I didn’t see it [lice],” she says of  a recent experience with one of her children. The boy complained about his head being itchy, and she had told him, “You’re not washing your hair good.”

“They’re just so tiny and hard to see,” she explains, “so I don't blame parents for missing it.”

To help with that problem, Cartwheel is developing an AI-powered lice detection app called Lice Lens, expected to be available in the spring, “You take a picture of what you’re seeing, and it will tell you if it’s lice or something else -- cookie crumbs, glitter… kids just put all kinds of exciting things in their hair.”

Also in the company’s natural products pipeline: a lice prevention spray and a treatment for (pink eye).

For now, though, Nit Happens is entering a huge market.

While head lice is tinged with shame  -- highly unfair since the bugs  reportedly only like clean hair, with the stigma caused by the disgust of others -- the condition affects an estimated six million to 12 million American children annually.

The U.S. lice treatment market, which includes both prescription drugs and OTC, was estimated at $320 million in 2024 and is expected to reach $500 million by 2032, according to S&S Insider.