Articles on seborrheic dermatitis

Everything You Need to Know About Dandruff

Dr. Apoorva Shah
Dandruff, also known as seborrhea, is a common-contagious condition of skin areas rich in oil glands (the face, scalp, and upper trunk) marked by flaking (overproduction of skin cells) and sometimes redness and itching (inflammation) of the scalp, varying in severity from mild flaking of the scalp to scaly, red patches.Dandruff - those dry, white flakes of skin you brush off your collar or shoulders - is essentially harmless. But it can be embarrassing and itchy. Dandruff really isn't about your hair, or how often you wash it. Instead, it's about the skin on your scalp.The normal skin yeast, Pityrosporumovale, lives in oil-rich skin regions and plays a role in this condition. Skin cells that grow and die off too fast are the problem. Exactly why that happens isn't clear. A very common fungus called malassezia may contribute to dandruff. This fungus lives on the scalp of most healthy adults without causing any problems. One theory is that the immune system of someone with dandruff may overreact to that fungus.Dandruff may be worse with stress, winter, and infrequent shampooing. Although there is no "cure" for dandruff, control is usually possible with frequent wash or medicated shampoos.Risk FactorsDandruff occurs in 15–20% of the population. The problem affects all races, may be a bit worse in men, and starts after puberty (although babies have a version called cradle cap). Dandruff peaks around the age of 40 and then may improve. Severe dandruff is frequently seen in people with Parkinson's disease and others with central nervous system problems, as well as in those with HIV infection.Signs and SymptomsThe scalp is itchy and flaky.One or more of the following areas may have patches of red, scaly skin: the scalp, hairline,forehead, eyebrows, eyelids, creases of the nose and ears, ear canals, beard areas, breastbone, mid back, groin, or armpit.Mild dandruff – only some flaking with or without redness in a few small areasModerate dandruff – several areas affected with bothersome redness and itchSevere dandruff – large areas of redness, severe itch, and unresponsive to self-care measuresCare GuidelinesMost cases of dandruff are easy to control. These include:Frequent (daily)shampooing or a longer lather time.Stopping use of any hair styling products.If it is mild flaking then apply oil to the scalp 3 times a week and wash it with the same frequency. But if it is associated with oily scalp then daily wash with mild scalp cleanser is advisable. It is not advisable to use oil in seborrheic oleosa or in condition of psoriasis.If all self care measures fail, get your scalp checked by a Trichologist.

Understanding Dandruff

Dr. Jolly Shah Kapadia, Dermatologist
Dandruff is seen as white or yellow flakes seen on your shoulders or in your hair. Dandruff flakes are actually dead skin cells that fall off your scalp. When you have dandruff, your scalp may look scaly or red and feel itchy or raw. Scratching or rubbing your head loosens the flakes. Does having dandruff mean dirty hair? Dandruff doesn't mean you have dirty hair. If you already have dandruff, not washing your hair enough can make your dandruff look worse because dead skin cells build up. What Causes Dandruff?Dandruff is believed to be caused by a fungus called Mallessezia furfur. This fungus usually lives on your skin, but too much fungus may lead to dandruff. Being exposed to a lot of dry air can cause skin to dry out and flake, which can look like dandruff.Dandruff tends to be worse during dry months. Cold, dry winter weather in particular can make dandruff worse. Sensitivity to hair care products (contact dermatitis). Sometimes sensitivities to certain ingredients in hair care products or hair dyes, especially paraphenylenediamine, can cause a red, itchy, scaly scalp. Shampooing too often or using too many styling products also may irritate your scalp, causing dandruff.Stress or fatigue can trigger or aggravate it, too.Dietary deficiency of zinc and a diet excess in saturated fats, refined sugars adds to the dandruff problemAre there other conditions that lead to a flaky scalp?Skin problems like acne, eczema, and psoriasis can cause a buildup of dead skin cells on the scalp. People with serious medical problems such as epilepsy, Parkinson's disease, and HIV are prone to developing dandruff. And, for unclear reasons, people recovering from a stroke, heart attack, or head injury are also more likely to have dandruff.Can Dandruff occur on any other body parts?Dandruff can also occur on forehead, eyebrows, eyelashes, or ears. Flaky skin on your chest -- or anywhere you have body hair -- could be a sign of dandruff, which is a mild form of seborrheic dermatitis. Do babies also get dandruff?When babies have seborrheic dermatitis, it's called cradle cap. The brown or yellow scales may be itchy. You may find it on the skin of a baby's scalp, eyelids, nose, and groin area. Cradle cap normally clears up on its own by the time the baby is 8 to 12 months old. Try putting vegetable oil on the baby's scalp for 10 minutes, then washing with a mild baby shampoo. Is dandruff harmful? Although having dandruff can be embarrassing, it's harmless. Can Dandruff cause hair fall?Dandruff doesn't directly cause hair loss, but scratching your scalp a lot could cause temporary hair loss.Is Dandruff contagious?Dandruff is not contagious: You can't catch it or pass it along to someone else. Does wearing a helmet or cap cause dandruff?Wearing a hat will not cause dandruff but it will aggravate the dandruff condition by not allowing sweat to evaporate.Can blow drying reduce dandruff?Blow drying may make your hair look beautiful for sometime, but it only damages your hair in the long run. It never contributes in the reduction of dandruff.Will Dandruff treatment decolorize my colour- treated hair?Most of the anti-dandruff shampoos available today are colour-friendly. They do not decolorize your perfectly coloured hair. You need not worry while treating dandruff about your coloured hair.How do I use anti-dandruff shampoo? Gently rub the shampoo into your scalp using the pads of your fingers. Leave the shampoo on your head for five minutes -- or as directed -- before you rinse. If you prefer the smell of your normal shampoo and conditioner, you can use those afterward. As your dandruff gets better, you may not need to use dandruff shampoo as often.Do I need to visit a Dermatologist for dandruff?Sometimes what seems like dandruff can be an entirely different condition. Head lice are itchy and lay eggs that look like dandruff, but they're harder to shake off or brush out. Or your scalp could be itching from ringworm, a fungus that causes dandruff-like flakes. With ringworm, you might also have round patches of hair loss and blistered, scaly areas on your scalp.If you've been using a dandruff shampoo for several weeks but still have dandruff, visit a Dermatologist. You should also see a doctor if your scalp is swollen or red, if your hair is falling out, or if you have a red, scaly rash on other parts of your body.

Dandruff- An Overview & Tips for Management

Dr. Sanjeev Gulati, Dermatologist
It is a popular name given to a non-inflammatory increased scaling of scalp where scaling (desquamation) is visible and active.It is a precursor of seborrhoeic Dermatitis & progression is though redness, greasiness, irritation and increased scalp scaling.Mostly it’s a cosmetic problem with flaking of scales on scalp, also involving face and shoulders.Dandruff is also associated with acne or may be part of psoriasis.Seborrhoeic Dermatitis may also involve the eyebrows, eyelids, ears, nasolabial creases, lips, axillae, umbilicus, sternum, groin & buttocks; and generally has crusted pink or yellow  patches of various shapes & sizes, with remissions and exacerbations.In infants, yellowish a brownish scales are seen an scalp, which are adherent & called “Cradle Cap”A common yeast Pityrosporum ovale, is found to be abundant in dandruff patients. Patients of Dandruff have to be approached from cosmetic angle to the treatment of related disorders.Patient’s History / Examination:-    An inquiry into – Severity, pruritus, frequency of hair washing / shampooing & seasonal variation is pertinent.    Also history of medication (Arsenic, Gold) Dietary deficiencies (Vitamin B Complex), Acne, Alcoholics, Psoriasis, HIV, Epilesy, Diabetes esp.in (Obese People), Malabsorption disorders,  are asked for     A simple visualization of scales, (yellowish, greasy / dry), under a magnifying lens is sufficient to gauge extent & severity of dandruff. An examination for associated alopecia (baldness) of scalp, secondary infection, eczematisation and type of scaling is in order. A scraping (KOH) of scales & rarely biopsy is required.Classification of Dandruff:-    It can be graded based on degree of scaling on a scale ranging from 0 to 10.    A practical grading into mild, moderate and severe forms is done on basis of severity of scaling, itching & evidence of inflammation, acne & seborrhea.Mild / Grade -I: -    Visible fine scaling, non itchy, non-inflammatory – of pure Cosmetic Importance.Moderate / Grade: II:- Larger scaling with itching, mild inflammatory changes, with diffuse alopecia a acne or seborrhea.Severe / Grade III: - Severely inflammatory, severe pruritus, thick scales, with. associated seborrhoeic dermatitis / psoriatic originPrinciples of Treating Dandruff :- 1.    Patients Education & explanation :- regarding a)    Emphasis that dandruff can generally be suppressed with regular treatment for years – permanent cure may not be there.b)    Cosmetic nature of disorder.c)    Seasonal Variation i.e. increases in winter & reduction in summer.d)    Importance of frequent washing of hair and scalp (to eliminate loose scales).e)    Avoid unnecessary use of excessive hair oil (greasy scaling), but minimal application at night to soften scales for easy dislodgement by shampoos.f)    Use of conditioner shampoos if dry scalp & shampoo for oily hair in those with greasy scalps.2.    Medical therapy is started with topical agents to control dandruff – lotion or shampoo formulations.3.    Systemic therapy started as a second line of therapy for resistant cases, very severe forms or if related to Psoriasis & seborrhoeic dermatitis4.    Specific therapy for associated conditions eg. Secondary infection, eczematisation & diffuse alopecia – are co- prescribedMANAGEMENT GUIDELINES FOR DANDRUFF:-

Learn How to Manage Dandruff!

Dr. Ramesh Maheshwari, Sexologist
Dry white flakes of skin, on your scalp is known as dandruff.It is not a health risk, but is a source of embarrassment.Some people have the wrong notion that it is because of bad hygiene or washing the hair often - this is a false belief. It is just that people having dandruff shed more skin then others.However some dermatologists suggest that is caused by a yeast fungus that is believed to breed in a combination of sebaceous oil and dead skin cells.Causes:A family history of dandruff.Excessive sweating of the scalp.Excessive mental and physical stress.Use of alkaline soaps.Cold dry winter season.Psoriasis of scalp.Seborrhoeic dermatitis.Improper carbohydrate and sugar consumption.Nutrient deficiencies – B-complex,essential fatty acids, selenium.Sign and symptoms:Flakes of skin which may be small and white or large greasy and yellow.Itching on scalp, eyebrows, nose or ears.It can be worse in winters.Dietary management:Avoid:Avoid fatty and oily food.Avoid dairy products (except yoghurt)– cheese, cottage cheese and seafood.Avoid sugar, white flour and chocolate.Avoid excess alcohol.Avoid stress.Even though dandruff is dry flaking skin do not normally apply excessive oil as it may provide an environment for yeast to breed.Do:Add one tea spoon of vinegar to the rinsing water after washing your hair.Before washing your hair, apply a mixture of 8 table spoon of pure organic peanut oil and 2 table spoon lemon juice and massage into the scalp. Leave it for 10-15 minutes then shampoo.You can replace oil with coconut milk or coconut water; leave it over night and shampoo.Wash hair with natural, herbal ingredients rather than chemical – take mixture of amla (Indian goose berri)powder, aritha (sapindus Laurifotius) powder and shikakai (Acacia Concinna)powder, soak it in water over night and wash hair with the mixture.Practice yoga, helps in relieving stress and will increase blood circulation.Natural live yoghurt is recommended as a natural conditioner.Avoid harsh hair dyes and hair creams.Softly massage your scalp when you shampoo or oil. This will help blood circulation and prevent skin from drying and cracking.Consume:Drink plenty of water.Eat large percentage of your diet as raw fruits and vegetables.Consume (3-4) – nuts and seeds daily.Consume linseed oil – 2 table spoon.Consumption of Aloe vera juice is also helpful.Consume Kelp and Japanese sea plants frequently as they supply many minerals like iodine which are better for hair growth and healing of the scalp.Increase intake of zinc in diet:-Shellfish, beef and other red meats,eggs and seafood, milk and milk products, nuts, sea plants especially Japanese sea.Consume diet rich in antioxidants like Vitamin A, Vitamin C and Vitamin E.Increase intake of foods that contain PUFA`s (poly unsaturated fatty acids): flax / linseed oil is the richest source of PUFA`s. Other oils that contain PUFA`s are safflower oil, soybean oil, maize oil, sesame oil, olive oil. As all oils are high in fats, its consumption should be limited. The intake of oils should not exceed 20 gms a day.Sesame oil and almond oil hinders the absorption of LDL (low-density lipoproteins), so it is advisable to use replace other cooking oils by sesame oil.Consume lots of Selenium:-Fish, shellfish, eggs, red meat,chicken, liver, grains, Brazil nuts, garlic, wheat germ and brewer's yeast.Consume lots of Vitamin B complex:-Liver, kidney, pancreas, yeast(Brewer's yeast), lean meat especially pork, fish, dairy products, poultry,egg, shrimps, crabs and lobsters.-Milk and milk products, green leafy vegetables, legumes, nuts, whole grain cereals.-Carrots, bananas, avocado,raspberries, artichoke, cauliflower, soy flour, barley, cereals, pasta, whole grains, wheat barn like rice and wheat germ, dried beans, peas and soybeans.

Try These Home Remedies to Get Rid of Dry and Itchy Scalp

Dr. Adil Hingora, Homeopath
An itchy scalp! Oops. Cause for concern as well as a reason for social embarrassment. Instead of anti-dandruff shampoos, have you tried some home remedies?A dry scalp can be an absolute social nightmare. If you ignore it (if you can, that is), it can actually worsen, leading to other complications. Of course, markets shelves are overflowing with ready made products that shout and scream for your attention. They are, however, chemicals after all. Looking for solutions at home is a much safer and better option. But before we tell you how to treat dry scalp, learn the underlying causes of a dry scalp. Extensive use of chemical products, shampoos and conditioners, long-term exposure to extreme temperatures (working in an air-conditioned office or spending long hours in the sun), or even over-styling your hair can lead to scalp dryness. Yes, your lifestyle could be responsible for a dry and itchy scalp. Fret not. If you’re looking for dry scalp home remedies, look no further. We’ve put together the easiest and the most common dry scalp treatments that you can do at home for you right here. Home remedies to get rid of dry & itchy scalp using natural ingredients: 1. An oil massage to restore the natural scalp moisture Raid your kitchen to see what oil you have. You can massage slightly warmed tea tree, coconut, olive, jojoba or sesame oil into your dry scalp. Let it sit there for 15-20 minutes and then rinse it off thoroughly. Just remember to dilute tea tree oil before applying it to your scalp. 2. Baking soda to reduce dandruff-causing fungiBaking soda is one of the most easily available kitchen ingredients. Make a paste with a little water and massage it into your scalp. You can also massage in some olive oil before applying the paste. Rinse off the paste after 10 to 15 minutes with your regular shampoo. 3. Lemon juice and honey to cleanse the scalpThe antibacterial properties of honey and the antiseptic nature of lemon combine to form this cleansing dry scalp treatment. Apply the blend and leave it on for 10-15 minutes before washing off. Don’t use lemon if you have broken or irritated skin as it may sting or worsen the problem. 4. Bananas and avocado to treat and conditionBananas are a multi-use goodie from nature. Not only will they ease the itching but also condition your hair. Mash two bananas and mix them well with a ripe avocado. Massage this mixture onto your scalp and leave it for half an hour. Rinse it off with a mild shampoo. 5. Aloe Vera for natural soothingNatural aloe vera gel is an excellent moisturising agent that also soothes a dry and itchy scalp. As far as possible, try to get fresh aloe gel. If you can’t, purchase the readymade gel easily available in the market. Massage it into your scalp gently with your fingers. Wash it off with a mild shampoo after 10-15 minutes. Prevention is always better than cure. Follow these 3 tips to avoid a dry & itchy scalp problems:Avoid using harsh chemicals or products on your hair.Avoid over-styling your hair using curlers or blowers.Eat a well-balanced diet that includes lean protein, leafy vegetables, fruits, whole grains, salmon, walnuts, flaxseed, and spinach.

7 Things No One Told You About Driving Away Dandruff

Dr. Sharad Kulkarni, Ayurveda
One of the worst nightmares for anyone is the sight of white flakes on the clothes or scalp - commonly referred to as the ‘white monster’. Well! This white monster is none other than sneaky dandruff - usually seen in the winters, as it is triggered by the dry climate.When suffering from dandruff, often there is itching and scaling of white flaky particles,sometimes associated with hair fall.Here are a few easy and untold home remedies to get rid of the dandruff:1. Fenugreek (methi seeds)Fenugreek (methi seeds)-one of the commonest kitchen herbs-is known to have anti-fungal, anti-bacterial and antiseptic properties that can provide effective relief from dandruff. All you need to do is soak some fenugreek seeds overnight so that they soften. Thereafter, grind the softened seeds to make a paste and apply it on the scalp overnight. Alternatively, you can also apply it 1 hour before the hair wash. With few days of this treatment, you can say good bye to dandruff.2. The green miracle of aloe veraAloe vera is another home remedy that you can try to treat dandruff. Simply apply some aloe vera gel on the scalp an hour before shampooing. This is known to provide relief from itching too. Besides, it gives a cooling effect and makes the hair lustrous.3. Diluted apple cider vinegarApple cider vinegar is an assured method to get rid of the dandruff. Its acidic nature balances the pH of the scalp that makes the growth of dandruff-related yeast difficult. All you need to do is mix 1/3 cup of apple cider vinegar in a litre of water.Thereafter, rinse your hair with this mix after regular shampoo wash.4. Tea tree oilMixing just few drops of tea tree oil to your regular shampoo or selecting a shampoo with tea tree oil helps to significantly improve the condition of dandruff.5. Baking soda as a defoliantBaking soda is a fantastic remedy for dandruff. It is known to reduce overactive fungi that can worsen dandruff. Thus, mixing this kitchen friendly baking soda to your mild shampoo and then washing as usual helps easy removal of flakes that are stuck to your scalp. Evidently, the coarse particles of the baking soda help in exfoliating thedead skin cells and absorb the excess oil of the scalp. Hence, it prevents the worsening of dandruff.6. Olive oil maskApplication of few drops of warm olive oil to the entire scalp a night before hair wash helps in moisturising the dry scalp. This provides nutrition to the dry scalp and,hence, prevents flaking and itching.Remember, regular use of any of the above-mentioned remedies along with balanced nutrition and care of your hair and scalp will definitely help you see great results in reducing dandruff.

Hair Care in Monsoon

Dr. Sadhana Deshmukh, Dermatologist
It is hard to take a good care of hair in the rainy season as the hair remains moist for a long time. Even after a shower, it takes really long to dry due to humid climate. Today, we will give you a few hair care tips for monsoon. Make a note and care your hair as much you do for your face.Certain scalp conditions, like fungal and bacterial infections and eczemas, become more prevalent during the monsoon, because of constant exposure to warm and humid atmosphere.The scalp is a unique environment – dark, warm, and moist. It is also a good place for micro-organisms to grow as sebum (sweat) and dead skin cells serve as its “nutritional” sources. Another factor that fuels trouble is potential friction or injury caused by brushing and styling. It’s no surprise then that dandruff is so common, everywhere. While monsoons may reportedly increase the chances of dandruff, the basic causes and tips for removing those dreaded flakes are the same – no matter what time of year. The fungus, Malassezia, is the microbe on your scalp that causes the irritation associated with dandruff. Everyone has it. It is a normal part of the scalp and is impossible to get rid of. Scalp oils, or sebum, are broken down by the fungus to produce smaller materials, called fatty acids. These fatty acids have been shown to be irritating to some people. It is this irritation that causes dandruff flakes and all of the other symptoms, like itching and dryness. The final factor is the individual’s skin irritation potential. Some people are quite sensitive to fatty acids, while others are not. This can range from severe dandruff and mild to severe flaking to little or severe itching.It has been reported that more cases of dandruff occur during summer. This is due to the fact that the fungus involved in dandruff may grow at an alarming rate in warm temperatures. However, the monsoon season, which offers a change in climatic conditions, can also encourage the growth of these microscopic organisms.Treat with careTreating dandruff for some people is a year-long reality. Those with high seasonal experiences, especially during monsoons, should treat their hair more carefully.Use an effective anti-dandruff shampoo with an active ingredient like zinc pyrithione, which attacks fungus and keeps it in check, regularly. This also helps reduce the tell-tale flakesNo switching between a cosmetic formulation and an anti-dandruff product! This reduces the effectiveness of anti-fungal actives and could leave you with flakes and bad odour. Zinc pyrithione, which is odourless, provides conditioning.Cut down on styling and styling products, as they may also attract dirt and grime during monsoons. Brush and comb gently, so as not to cause scalp damage. Remember to dry hair completely before leaving the house. It is important to keep the scalp dry, so, avoid stepping out when it's raining-even. In case your hair gets wet,make sure you wash it thoroughly with a mild cleanser and use a conditioner thereafter.Regular washes keep the fungus in check and reduce the sebum on your scalp. In addition to playing a role in dandruff, sebum also attracts dirt, dust, and pollution to your hair, making it look dull, weak, dried out and brittle.Conditioning your hair becomes twice as important during this season. If you have sticky hair; just opt for a light conditioner that is suited for limp, oily hair. The trick is to pick the right product. The conditioner should be applied to the hair ends and not on scalp. Application on scalp can cause increase in dandruff especially in monsoon.Arm yourself well in advance with products that suit your hair type. Don't just buy products off the shelf, driven by enticing advertisements. It may require a few test-runs but once you have found 'the one', stick to it. A lot of people have a combination hair-scalp type: for instance, the scalp is greasy but the hair is dry. In such a case, opt for a mild cleansing shampoo-one than removes the grime without drying the hair. Another common complaint during monsoon is frizziness. A good serum can help tame unruly hair, giving you a smoother finish.

Sensitive Skin: Facts and Myths

Dr. Jeetendra Khatuja, Dermatologist
WHAT IS SENSITIVE SKIN?Sensitive skin is less tolerant to frequent and prolonged use of cosmetics and toiletries. It is self-diagnosed and typically unaccompanied by any obvious physical signs of irritation. WHAT CAUSES SENSITIVITY?With the change in lifestyle and also with increased opportunity to use many new brands of cosmetics and toiletries, there has been an increase in females complaining of unique sensation in their facial skin.PROBLEMS CAUSED BY SENSITIVE SKIN?Subjective perceptions (stinging, burning, pruritus, and tightness) of sensitive skin are noticed immediately following cosmetic product application or delayed by minutes, hours, or days,especially on face skin.WHO IS AT RISK FOR DEVELOPING SENSITIVE SKIN? The condition is found in more than 50% of women and 40% of men, creating a sizable demand for products designed to minimize skin sensitivity.Commonly affects females, young adults aged between 18 and 50 years, hormonal differences in women producing increased inflammatory sensitivity, cultural habits in developed countries, and environmental factors like winter, stress, and atopic dermatitis are thought to promote sensitive skin HOW TO DIAGNOSE SENSITIVE SKIN?It is self-diagnosed and typically unaccompanied by any obvious physical signs of irritation.Good numbers of invasive and non-invasive tests are designed to evaluate and predict the sensitive skin.WHAT IS THE SOLUTION FOR SENSITIVE SKIN? Management includes guidelines for selecting suitable cosmetics and toiletries in sensitive skin individuals.Certain "do's" while selecting the cosmetic for sensitive skin are the following:Powder cosmetics preferredUse cosmetics which are easily removable by waterAlways use fresh cosmeticsUse black-colored eyeliner and mascara\Select pencil form of eyeliner and eyebrow cosmeticsSelect light earth tone eye shadowsSelect physical sunscreen agentPurchase cosmetics products with less than 10 ingredientsNo nail polishesUse powder/cream formulations of facial foundations.Myth 1: HYPOALLERGENIC MEANS NON-IRRITATINGTruth: It doesn't necessarily mean gentle or free of allergens. There are no set standards for this term. You need to know what you're allergic to and look for it on the label.Myth 2: SENSITIVE SKIN TYPES CANT EXFOLIATETruth: Yes, rosacea and allergic types should skip it—those dead skin cells act as a protective barrier to block irritants. But acne-prone skin needs exfoliation to keep pores clear.Myth 3: RETINOIDS ARE OFF-LIMITSTruth: Anyone can use a retinol. Just lessen its harsh effects by layering it over a moisturizer so absorbs less into your skin.

Eczema in Children: Daily Care Tips.

Dr. (Lt Cdr) Siddharth Garekar, Dermatologist
Hi everyone, This blogpost is for people who have atopic dermatitis (eczema) and parents of a child/ baby with atopic dermatitis. Atopic Dermatitis is a distressing disease for the parents and like any other Paediatric Dermatologist in Gurgaon, we frequently spend a lot of time consulting them about daily do’s and don’ts.  Here, we highlighted a few things you should be doing for your little one, in order to minimize flares of the disease.The guiding principle:The most crucial aspect of Eczemz/ Atopic Dermatitis is the preservation of skin moisture. It is only through the maintenance of this moisture that we can break the itch scratch cycle.General care:Use cotton clothes, avoid synthetic materials and especially wool.In winters, the first layer has to be cotton and then a woollen, to avoid direct contact with wool.Keep child’s fingernails filed short.Use regular laundry detergent, but rinse and clean well. No bleach or fabric softener.Wash new clothes before wearing them to remove irritating dyes and fabric finishers.Avoid drying laundry outside during the pollination season.Air the room out in all seasons.Avoid dust, animal hair etc.No tobacco smokeWriting a diary to note any triggers that cause flare-ups.Bathing:Water temperature should be between 32° and 34° (lukewarm)Showers are better. A short duration, a five minute shower every day.Turn the water off when washing to decrease contact time.For those who like baths and for children: add a liquid emollient to the bath to neutralize water hardness. 5-10 minutes at most, to minimise the contact time with the municipal water.Wash with soap-free products (dermatologist recommended) as the pH is closest to that of the skin and does not aggravate skin dryness.Wash hair with dermatological shampoos that are soft or intended for frequent use.Dry by patting, as rubbing reactivates itching. Leave the body wet after bathing.Moisturization in atopic dermatitis:5-minute, lukewarm baths followed by the application of a moisturizer. (Dermatologist recommended)Keep the moisturizer in the bathroom and apply all over the body while wet, to seal in moisture and allow water to be absorbed through the skin.Moisturize 2-3 times a day.Wash your hands before applying a moisturiser.Apply a liberal amount of the moisturizer, warming it first between your hands, and apply in large circular movements. (Massage)Do not apply an emollient on raw/ red skinDo not rub the skinWhen to contact a Dermatologist:Condition not responding to moisturizersSymptoms continue to worsenThere are signs of infection fever, redness, or pain