What to do for Itching and Scalp Scale

Itching and scalp scale are common and frustrating symptoms for patients with ichthyosis, particularly in children as they are unable to “resist the itch.” However there are some tried and true practices that can help soothe the itch and make your child more comfortable.

• Itching can be treated with oatmeal and oil baths and plenty of cream or lotion. Lotions with oatmeal as an active ingredient can be soothing as well. If the itching persists, your doctor can prescribe oral and/or topical medications.
• Apply cool compresses to the affected areas may help to relieve the itch.
• To remove difficult scales on the scalp, try applying your favorite lotion liberally to the scalp, then put on a shower cap or other occlusive garment for the night. In the morning, shampoo, massage, and comb out.
• Many parents have also reported using coconut oil with great success for softening and removing scalp scale. 
• Place coconut oil or baby oil generously on the scalp while bathing.Let it soak for 30 minutes.Wash and rinse.Immediately comb out the scales that are now “mush” with a fine tooth comb trying to get underneath the scales and combing is lots of different directions.

 “We doused her head with baby oil, let it set and then combed with a fine tooth comb.  You just have to be careful and go SLOW as you have the potential to lift large scales that aren’t ready to come off.” -FIRST Parent, Kelly Robinson

Scratching and Fingernails 

Infants with ichthyosis often have fast-growing nails and may unintentionally scratch themselves a little too deep.  Take care to keep them trimmed just below the fingertips.  You might want to try adult cuticle nippers or finger nail files, instead of baby nail trimmers. Babies tend to scratch the upper arch of the ear, behind the ears, and their noses.  You can put socks on the hands of your sleeping infant, but they learn to take them off after a few months. 

Please keep in mind that covering your baby’s hands all the time could delay development of hand-eye coordination.  If your baby seems to be scratching a lot, he or she may need an extra bath and lotion to feel comfortable, or they may need to be evaluated by your doctor for a skin infection.

Also, it’s important to teach children not to scratch with their finger nails instead rubbing with the flat part of the fingers. 

TeleIchthyosis - Since ichthyosis is a rare condition, sometimes your healthcare practitioner will need guidance from ichthyosis medical experts. Remember that FIRST has a TeleIchthyosis portal, where medical staff can upload questions and photos and an ichthyosis expert will respond as soon as possible. If it is an urgent matter please call the FIRST office at 215-997-9400 and we will reach out to a member of FIRST's MSAB.

Here's why Pediatric Dermatologist, Dr. Robert Silverman, supports FIRST.

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The information on these pages has been provided through the generosity of the Ace in the Hole Foundation.

This information is provided as a service to patients and parents of patients who have ichthyosis.  It is not intended to supplement appropriate medical care, but instead to complement that care with guidance in practical issues facing patients and parents.  Neither FIRST, its Board of Directors, Medical & Scientific Advisory Board, Board of Medical Editors nor Foundation staff and officials and sponsoring foundations endorse any treatments or products reported here.  All issues pertaining to the care of patients with ichthyosis should be discussed with a dermatologist experienced in the treatment of their skin disorder.