From the clinic #6: Atopic eczema and hair care

author/source: DrB


In clinic we often find ourselves thinking “Don’t forget the scalp - it’s skin, and it gets atopic eczema too!”.

Not always of course. But what is especially common is for scalp eczema to be overlooked when eczema treatment is being planned.

And then, when we get into discussing treating scalp eczema, we need to discuss washing the hair - and which shampoo, and which hair conditioner to use.

Scalp eczema is more likely if the scalp is allowed to become dry, and washing hair can lead to a dry scalp. For the rest of the body, the use of a suitable moisturiser as a soap substitute is recommended. How about the scalp?

A suitable shampoo is generally the answer, but in the same way hair comes in different textures, shampoos are now available in a wide variety of different formulations. Instead of massaging the hair and scalp with a moisturiser, and then rinsing out with warm water, a suitable shampoo would usually be one recommended for dry hair - the oil-stripping formulation will then be relatively gentle - and usually one with an added conditioner, which, amongst other attributes, will have an oil that acts as a moisturiser for the scalp.

Shampoos come with a wide price range: expensive does not mean necessarily better, but perhaps also avoid the cheapest. Trial and error is generally the only way.

And always check the label! A problem with a particular shampoo can be one of the ingredients. Aqueous Cream as a skin moisturiser fell from grace when the skin irritant effects of one of its constituents - sodium lauryl sulphate - was identified. The same ingredient is in some shampoos, and has the same irritant effect on a sensitive scalp!

One or two other useful tips on hair care:

  • Try washing the hair less often!
  • Avoid blow drying: it really dries the scalp!
  • Throw away your sharp combs and brushes - we know why you like them!

And on a final note - there is the “no-poo” approach to hair care: “no-poo” meaning washing the hair without a commercial shampoo!
But washing the hair in a solution of baking soda and rinsing it in apple cider vinegar may not appeal to everyone, and watch out with baking soda.
It really de-greases - so, not recommended here!

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