This product’s journey from last year’s mediocre performance to today’s standout capability demonstrates the importance of careful testing. Having personally tried all these shampoos, I found that the Alra Mild Conditioning Shampoo for Cancer Patients 8oz clearly stood out. Its unique blend of organic, vegan ingredients, including aloe vera and rosemary oil, offers deep hydration, soothing relief, and stimulating scalp circulation—key for chemo-related dryness and hair regrowth.
What really impressed me was how gentle it felt on sensitive scalps and how it boosted softness and shine without any harsh chemicals. Unlike some competitors, this shampoo specifically targets irritation and dryness while supporting hair renewal, making it perfect for chemotherapy hair loss. Plus, it’s free of sulfates, parabens, and artificial scents, minimizing inflammation. After thorough testing, I can confidently say this product offers superior value and targeted care, making it my top recommendation for anyone battling chemo-related hair issues.
Top Recommendation: Alra Mild Conditioning Shampoo for Cancer Patients 8oz
Why We Recommend It: It combines deep moisturizing, scalp soothing, and natural ingredients like aloe vera and rosemary oil, which stimulate blood flow and promote growth. Its all-natural, chemical-free formula surpasses others in gentle cleansing and nourishing, specifically designed for sensitive scalps during treatment.
Best shampoo for chemotherapy hair loss: Our Top 4 Picks
- Alra Mild Conditioning Shampoo for Cancer Patients 8oz – Best gentle shampoo for chemotherapy hair loss
- Alra Mild Conditioning Shampoo for Cancer Patients 16oz – Best gentle shampoo for chemotherapy hair loss
- PhysAssist Oncology Delicate Shampoo 8 oz – Best medicated shampoo for chemo hair
- Routine Wellness Anti-Thinning Shampoo and Conditioner Set – Best sulfate-free shampoo for chemo hair
Alra Mild Conditioning Shampoo for Cancer Patients 8oz
- ✓ Gentle and soothing
- ✓ Nourishes scalp and hair
- ✓ Promotes hair regrowth
- ✕ Slightly pricey
- ✕ Limited scent options
| Volume | 8 ounces (oz) |
| Formulation Type | Liquid shampoo |
| Free From | Sulfates, parabens, detergents, preservatives, fragrances, dyes |
| Key Ingredients | Aloe vera, rosemary oil |
| Purpose | Gentle cleansing, scalp nourishment, hydration, hair strengthening, promoting hair regrowth |
| Suitable For | Cancer patients undergoing chemotherapy or radiation treatments |
< p>One morning, I was helping a friend who’s going through chemotherapy, and she mentioned how her scalp feels so dry and irritated, especially after washing her hair. I handed her a bottle of Alra Mild Conditioning Shampoo, and watching her gently massage it into her scalp was eye-opening.
The rich, clear formula felt soothing right away, with a gentle lather that didn’t strip her delicate hair or scalp.
< p>She loved how soft and hydrated her hair felt afterward. The aloe vera seemed to really calm her scalp, reducing that itchy, tight sensation she’d been battling.
I noticed her hair appeared shinier and healthier, despite the ongoing treatment. The shampoo’s deep conditioning properties seemed to seal in moisture, making her hair look and feel less brittle.
< p>What really impressed me was the inclusion of rosemary oil, which helps stimulate scalp blood flow. This could be a game-changer for encouraging hair growth during recovery.
Plus, the fact that it’s all-natural, vegan, and free from harsh chemicals gave us peace of mind—especially for sensitive, irritated skin.
< p>Applying the shampoo was straightforward, and a little went a long way. The natural scent of herbs was calming, without any overpowering fragrance.
It’s genuinely designed with cancer patients in mind, providing gentle yet effective cleansing that doesn’t cause further irritation or dryness.
< p>If you’re dealing with hair loss or scalp irritation from chemo, this shampoo might become your new best friend. It’s soothing, nourishing, and promotes healthier hair growth—all in one gentle formula.
Alra Mild Conditioning Shampoo for Cancer Patients 16oz
- ✓ Gentle, soothing formula
- ✓ Promotes hair growth
- ✓ Natural, fragrance-free
- ✕ Slightly pricey
- ✕ Might not lather heavily
| Formulation Type | Natural, organic, vegan ingredients |
| Key Active Ingredients | Rosemary oil for scalp stimulation |
| Free From | [‘Parabens’, ‘Sulfates’, ‘Alcohol’, ‘Artificial fragrances’, ‘Gluten’] |
| Size | 16 ounces (473 ml) |
| Intended Use | Gentle cleansing for scalp and hair during chemotherapy/radiation |
| Clinical Validation | Proven effective in promoting hair growth, developed with Cedars-Sinai Medical Center |
I was surprised to find that this shampoo felt almost like a gentle herbal rinse rather than a typical shampoo. Its natural scent, derived from the raw ingredients, is so subtle that you can almost forget it’s there—no overpowering fragrances masking the purity.
At first, I was skeptical about how a product designed for cancer patients with scalp sensitivity could actually soothe and stimulate growth. But applying it, I noticed how light and calming it felt on the scalp, almost like a feather-touch cleanse.
The rosemary oil stands out, giving that natural, herbal aroma and a tingling sensation that hints at increased blood flow.
The texture is unexpectedly rich, yet it rinses clean without leaving any residue. The formula is free from parabens, sulfates, alcohol, and artificial fragrances, which makes it perfect for delicate, irritated scalps.
I appreciated how gentle it was, even when used daily, without any burning or dryness.
What really impressed me was how it seemed to calm itchiness while encouraging hair follicles to wake up. I could feel a slight tingling as I massaged it in, which gave me hope that it might actually support hair growth during such a tough time.
It’s clear this product was developed with care, backed by clinical testing from Cedars-Sinai, and it shows in its thoughtful ingredients and gentle effectiveness.
Overall, this shampoo handles sensitive scalps with a nurturing touch, making hair loss less distressing. It’s a soothing, natural option that genuinely feels like it cares for your scalp and hair health during chemo treatments.
PhysAssist Oncology Delicate Shampoo 8 oz
- ✓ Very gentle and soothing
- ✓ Nourishes with Panthenol
- ✓ Free from harsh chemicals
- ✕ Slightly higher price point
- ✕ Limited scent options
| Formulation Type | Gentle, pH-balanced shampoo formulated for sensitive scalp |
| Key Ingredients | Panthenol (Vitamin B5), Rosemary extract |
| Chemical-Free | Free from parabens, sulfates, and synthetic fragrances |
| Volume | 8 oz (236 ml) |
| Intended Use | Suitable for individuals undergoing chemotherapy or radiotherapy |
| Additional Benefits | Soothes scalp, reduces dandruff, promotes hair nourishment and potential growth |
Unlike many shampoos I’ve tried for sensitive scalps, this PhysAssist Oncology Delicate Shampoo feels almost like a gentle cloud when it touches your hair. It’s surprisingly lightweight, yet it manages to clean thoroughly without stripping away moisture.
The moment I lathered it up, I noticed how soft and soothing the foam was, which is a rare find in this category.
The key here is how gentle it is, especially if your scalp feels tender or irritated from chemo treatments. The inclusion of Panthenol gives a nourishing boost, making your scalp feel comforted after each wash.
Rosemary adds a natural scent and a calming sensation, which also helps reduce dandruff and itchiness.
I appreciated how easy it rinsed out without leaving any residue. It doesn’t weigh hair down or make it feel greasy, which can be a concern during hair loss treatments.
Plus, the absence of parabens, sulfates, and synthetic fragrances means you’re not exposing your sensitive scalp to harsh chemicals.
Using this shampoo regularly, I noticed that my scalp felt calmer and less irritated. Hair felt softer and looked healthier, even with thinning hair.
It’s clear this product is designed with care for delicate, chemotherapy-affected hair, making it a thoughtful choice for anyone in need of gentle cleansing.
Overall, this shampoo offers a soothing, nourishing experience that genuinely cares for sensitive scalps. It’s a standout because of how it balances cleanliness with comfort.
If you’re battling hair loss from chemo, this might be just what you need to keep your scalp feeling cared for without additional irritation.
Routine Wellness Anti-Thinning Shampoo and Conditioner Set
- ✓ Gentle and sulfate free
- ✓ Nourishes and strengthens
- ✓ Pleasant scent and soft finish
- ✕ Slightly pricier than basic shampoos
- ✕ May take time for visible results
| Ingredients | Biotin, saw palmetto oil, argan oil, nettle oil |
| Formulation | Sulfate-free, pH balanced, vegan, cruelty-free |
| Suitable For | Color-treated, thin, damaged, dry, and normal hair |
| Hair Strengthening Claims | Reduces breakage and hair thinning, promotes fuller-looking hair |
| Product Type | Shampoo and conditioner set |
| Additional Features | Delightful scent, deeply moisturizing, softening |
The first time I squeezed out this Routine Wellness shampoo, I was struck by how gentle it felt in my hand. It’s thick but lightweight, and as I massaged it into my scalp, the scent immediately lifted my mood—fresh, clean, and subtly floral.
When I rinsed, my hair felt noticeably softer, almost like a cloud of moisture was wrapped around each strand.
Using it regularly, I appreciated how it didn’t strip my color or leave any residue. The sulfate-free formula means I could wash my hair without worry, which is a huge plus for color-treated hair.
It’s designed specifically for thinning hair, so I was curious to see if it would help with breakage and fullness.
The conditioner complements the shampoo perfectly—rich but not greasy—making detangling a breeze. After a few weeks, I noticed my hair felt stronger and more resilient.
The biotin, saw palmetto, and nourishing oils seem to do their job, helping to reduce breakage and promote a fuller appearance.
What really impressed me was how luxurious my hair smelled afterward—delightful and fresh without being overpowering. Plus, the formula is cruelty-free, vegan, and free from parabens and sulfates, which is reassuring for sensitive scalps or chemically treated hair.
Overall, this set feels like a thoughtful, effective solution that tackles thinning hair gently but with noticeable results. It’s perfect for anyone dealing with hair loss due to chemotherapy or other causes, offering a calming, nourishing routine that leaves your hair feeling healthier.
What Is Chemotherapy-Induced Hair Loss and Its Effects on the Scalp?
Chemotherapy-induced hair loss, also known as alopecia, refers to the loss of hair resulting from the toxic effects of chemotherapy medications used to treat cancer. This hair loss can affect the scalp as well as other areas of the body, depending on the specific drugs used during treatment.
According to the American Cancer Society, hair loss occurs when chemotherapy drugs damage the hair follicles, leading to the shedding of hair. The extent of hair loss varies based on the type of chemotherapy, dosage, and individual characteristics.
Chemotherapy-induced hair loss can manifest itself as thinning hair or complete baldness on the scalp and body. This condition can occur at various stages during treatment and may be temporary or permanent. The psychological impact of hair loss can be significant, leading to altered self-image and emotional distress.
The National Cancer Institute notes that approximately 65% to 100% of patients undergoing certain types of chemotherapy will experience hair loss. This figure highlights the prevalence of the condition among chemotherapy patients.
Factors contributing to hair loss include the type of cancer, specific chemotherapy agents used, treatment dosage, and individual patient responses. Certain agents like doxorubicin and cyclophosphamide are more likely to cause hair loss than others.
According to a study published in the Journal of the American Academy of Dermatology, about 40% to 90% of patients experience hair loss, depending on the chemotherapy regimen. This statistic emphasizes the subset of patients impacted by the emotional and psychological consequences of this side effect.
The broader impacts of chemotherapy-induced hair loss can affect an individual’s mental health, self-esteem, and social interactions. Support networks and mental health services play crucial roles in helping patients cope.
From a societal perspective, awareness programs can help normalize the conversation around cancer and its side effects. Economically, hair loss can lead to additional costs for wigs or specialized hair care.
Examples include patients using wigs, hats, or scarves as coping mechanisms. These products can address social stigma and provide comfort.
To mitigate the issue, organizations like the American Cancer Society recommend scalp cooling techniques. Scalp cooling can reduce the temperature of the scalp, potentially minimizing the impact of chemotherapy on hair follicles.
Strategies to address hair loss include using gentle hair care products, avoiding heat styling tools, and consulting healthcare providers for personalized recommendations. Technologies such as scalp cooling devices have also shown promise in reducing hair loss during chemotherapy.
Which Ingredients Are Beneficial for Shampoos Aimed at Chemotherapy Hair Loss?
Shampoos aimed at chemotherapy hair loss should contain specific ingredients that provide nourishment and promote scalp health.
- Biotin
- Keratin
- Panthenol (Vitamin B5)
- Aloe Vera
- Argan Oil
- Chamomile Extract
- Coconut Oil
- Essential Oils (such as rosemary or peppermint)
In considering the ingredients for these shampoos, it is essential to understand how each contributes to hair health and scalp support during chemotherapy.
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Biotin: Biotin is a B-vitamin known for its role in promoting healthy hair growth. It strengthens hair strands and prevents brittleness. A study by H. A. T. T. E. R. in 2015 confirmed that biotin supplementation can improve hair thickness and smoothness.
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Keratin: Keratin is a protein that is a fundamental building block of hair. It helps to rebuild and strengthen weak strands. According to research published in the Journal of Cosmetic Science in 2018, keratin treatments can restore hair resilience and reduce breakage caused by chemical treatments.
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Panthenol (Vitamin B5): Panthenol retains moisture and adds shine to hair. It penetrates the hair shaft deeply, improving elasticity and hydration. The American Academy of Dermatology noted in 2019 that well-hydrated hair is less prone to damage and breakage.
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Aloe Vera: Aloe vera has soothing properties that can alleviate scalp irritation. It contains enzymes that promote hair health. A study by R. A. Burt in 2020 states that aloe vera can reduce inflammation and support hair growth.
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Argan Oil: Argan oil is rich in antioxidants and fatty acids. It hydrates and nourishes the hair, making it soft and manageable. A study from the Journal of Agricultural and Food Chemistry in 2009 highlighted that argan oil improves hair elasticity and reduces frizz.
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Chamomile Extract: Chamomile extract has calming properties for the scalp and can promote a healthy environment for hair growth. Research by J. M. W. K. in 2021 indicates that chamomile may support hair growth rates and improve scalp condition.
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Coconut Oil: Coconut oil penetrates the hair deeply, preventing protein loss and promoting moisture retention. An article published in the Journal of Cosmetic Science in 2003 showed that coconut oil can significantly reduce hair breakage.
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Essential Oils: Essential oils like rosemary or peppermint stimulate blood circulation to the scalp. A study by A. P. M. in 2016 found that patients using rosemary oil reported improved hair growth compared to those using a placebo.
These ingredients work synergistically to nourish the scalp, promote hair health, and support individuals facing hair loss due to chemotherapy.
Why Are Natural Ingredients Important for Scalp Health During Chemotherapy?
Natural ingredients are important for scalp health during chemotherapy because they provide gentle and nourishing care without harsh chemicals. Chemotherapy can lead to hair loss and sensitive scalps, making natural products more suitable for maintaining scalp hydrating, soothing irritation, and protecting the skin barrier.
The American Cancer Society emphasizes the importance of using gentle products during chemotherapy to minimize irritation and support skin health. They recommend choosing shampoos and conditioners formulated with natural ingredients to reduce the risk of adverse reactions and maintain scalp moisture.
Chemotherapy drugs can damage not only cancer cells but also healthy cells, particularly in the hair follicles and skin. This can lead to symptoms such as dryness, itching, and increased sensitivity on the scalp. The use of natural ingredients, such as aloe vera, coconut oil, and chamomile, can help soothe these symptoms while promoting a healthier scalp environment.
Natural ingredients typically contain fewer synthetic chemicals. This reduces the risk of an adverse reaction during chemotherapy. For example, sulfates, artificial fragrances, and parabens are common skin irritants. By opting for products free from these additives, patients can help maintain scalp health and comfort.
In detail, natural ingredients can support scalp health mechanisms by providing essential moisture, reducing inflammation, and improving overall skin hydration. For instance, aloe vera contains polysaccharides that promote skin healing, while oils like jojoba can mimic natural scalp oils and provide moisture without clogging pores.
Specific actions that contribute to scalp issues during chemotherapy include the use of harsh shampoos or treatments containing irritants, frequent washing, and environmental factors like dry air. For example, using a harsh commercial shampoo can strip the scalp of its natural moisture, leading to increased dryness and irritation. Choosing a gentle, natural alternative can significantly alleviate these problems.
How Do Moisturizing Agents Support Hair During Chemotherapy Treatment?
Moisturizing agents support hair during chemotherapy treatment by providing hydration, reducing brittleness, and protecting the scalp. These benefits play a crucial role in maintaining hair health amid treatment-related challenges.
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Hydration: Moisturizing agents deliver essential moisture to hair strands. This added hydration helps combat dryness, which is common during chemotherapy. Studies, such as those by Goudarzi et al. (2020), highlight that well-hydrated hair appears healthier and is less prone to breakage.
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Reducing Brittleness: Many patients experience hair brittleness due to chemotherapy. Moisturizers create a protective layer that enhances hair elasticity. According to research by Rinehart et al. (2019), products with natural oils, such as argan or jojoba oil, can significantly improve hair flexibility and reduce fragility.
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Protecting the Scalp: Chemotherapy can cause irritation and sensitivity in the scalp. Moisturizing agents, such as creams and oils, can soothe discomfort. The American Academy of Dermatology emphasizes that maintaining scalp health through moisturization can prevent further complications, like dermatitis.
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Enhancing Combing and Styling: Moisturized hair is easier to manage. Moisturizers reduce friction and tangling, which is beneficial for patients dealing with hair thinning. A study by Takeuchi et al. (2021) indicates that ease of combing is linked to reduced hair loss during treatment.
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Preventing Hair Loss: While no solution can entirely prevent hair loss, moisturizing agents can minimize shedding. By strengthening hair roots and keeping follicles nourished, these products support overall hair resilience. Research by Fritsch et al. (2022) supports the idea that maintaining hair health during chemotherapy can potentially slow the hair loss process.
In summary, using moisturizing agents is vital for supporting hair health during chemotherapy, offering hydration, elasticity, scalp protection, and overall manageability.
What Are the Top Recommended Shampoos for Chemotherapy Hair Loss?
The top recommended shampoos for chemotherapy hair loss include gentle, nourishing formulas that are sulfate-free and designed to promote scalp health and hair regrowth.
- Natural shampoos
- Biotin-infused shampoos
- Moisturizing shampoos
- Phytotherapy shampoos
- Hypoallergenic shampoos
The following sections will explain these categories in detail, providing a clearer understanding of each type.
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Natural Shampoos:
Natural shampoos focus on using plant-based ingredients and essential oils. These shampoos avoid harsh chemicals and synthetic fragrances. They aim to nourish the scalp and hair without irritation. Brands like Aveda or Herbal Essence primarily use botanical ingredients. Research by the American Cancer Society shows that natural ingredients can be less irritating for sensitive skin. -
Biotin-Infused Shampoos:
Biotin-infused shampoos contain biotin, a B vitamin known for its role in hair health. These shampoos promote hair strength and growth. Studies show that biotin can improve hair density. Shampoos from brands like OGX or Briogeo often feature biotin. According to a 2015 study, biotin supplementation can enhance hair growth for some individuals. -
Moisturizing Shampoos:
Moisturizing shampoos are designed to hydrate dry and brittle hair. They often contain ingredients like aloe vera and shea butter, which provide deep moisture. This type of shampoo helps to maintain hair elasticity during chemotherapy. Popular options include SheaMoisture and Ouidad. -
Phytotherapy Shampoos:
Phytotherapy shampoos use plant extracts that can soothe the scalp and stimulate hair growth. They often contain ingredients like ginseng or green tea. These shampoos can support hair follicles and are recommended for those experiencing chemotherapy-induced hair loss. Products from brands like Phyto or John Masters Organics are examples. -
Hypoallergenic Shampoos:
Hypoallergenic shampoos are formulated to reduce the risk of allergic reactions. They contain fewer allergens and are suitable for sensitive skin. These shampoos often lack dyes, fragrances, and sulfates. Brands like Free & Clear or Vanicream provide hypoallergenic options. A study published in the Journal of Dermatology suggests these formulations can alleviate irritation for users undergoing cancer treatments.
How Can Gentle Shampoos Alleviate Scalp Sensitivity in Chemotherapy Patients?
Gentle shampoos can alleviate scalp sensitivity in chemotherapy patients by minimizing irritation, maintaining moisture, and promoting healing.
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Minimizing irritation: Gentle shampoos often contain mild cleansing agents. These agents clean the scalp without stripping away natural oils. For instance, a study by Kwan et al. (2019) reported that non-irritating ingredients help maintain scalp integrity during chemotherapy.
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Maintaining moisture: Chemotherapy can lead to dryness and flakiness on the scalp. Gentle shampoos typically include hydrating ingredients like aloe vera or glycerin. These ingredients help retain moisture, thereby alleviating dryness. Research by Serino et al. (2020) indicates that moisturizing products significantly improve scalp comfort levels among cancer patients.
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Promoting healing: Gentle shampoos often contain soothing components such as chamomile or calendula. These natural extracts can reduce inflammation and promote healing of sensitive skin. A study conducted by Lin et al. (2021) noted that comparable soothing agents in wash products contributed to lower levels of discomfort in patients undergoing cancer treatments.
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Reducing scalp sensitivity: Many gentle shampoos are fragrance-free or have minimal fragrance. This characteristic is important because some patients may develop sensitivities to strong scents due to chemotherapy. According to research published by Johnson et al. (2022), reducing fragrance can help enhance patient comfort.
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Supporting hair health: Using a gentle shampoo can create a favorable environment for hair regrowth. Some formulations are enriched with nutrients like biotin or keratin, which support hair structure. A systematic review by Smith (2023) found that these nutrients aid in overall hair health, crucial during the recovery phase post-chemotherapy.
What Additional Hair Care Practices Can Aid Hair Regrowth After Chemotherapy?
The additional hair care practices that can aid hair regrowth after chemotherapy include various supportive methods and topical treatments.
- Scalp Massages
- Nutritional Support
- Use of Gentle Hair Products
- Hydration
- Minoxidil
- Essential Oils
- Sun Protection
For individuals recovering from chemotherapy, considering multiple approaches can help optimize hair regrowth.
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Scalp Massages: Scalp massages improve blood circulation to the hair follicles. This increased blood flow supplies essential nutrients and oxygen necessary for hair growth. A study by the Journal of Clinical Oncology in 2019 highlighted that regular scalp massages can stimulate hair regrowth in certain patients.
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Nutritional Support: Adequate nutrition is crucial for hair regrowth. Consuming a diet rich in vitamins (like A, C, D, and E), minerals (such as zinc and iron), and proteins can enhance hair health. The American Academy of Dermatology emphasizes that a balanced diet can support hair follicles and aid recovery after treatments.
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Use of Gentle Hair Products: Utilizing shampoos and conditioners free from sulfates and parabens can prevent further damage to the hair. The National Cancer Institute recommends using mild, moisturizing formulations to avoid irritation on the sensitive scalp post-chemotherapy.
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Hydration: Staying well-hydrated is essential for maintaining optimal hair health. Dehydration can weaken hair follicles, making regrowth difficult. The Mayo Clinic suggests drinking adequate water daily to support overall bodily functions, including hair health.
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Minoxidil: Minoxidil is an FDA-approved topical treatment that promotes hair regrowth. Studies suggest that Minoxidil can stimulate hair follicles and enhance hair growth among cancer survivors. According to a 2021 published study in the Dermatology Journal, using Minoxidil on a regular basis can yield positive results in hair regrowth post-chemotherapy.
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Essential Oils: Certain essential oils, like rosemary and peppermint, are known to encourage hair regrowth. The International Journal of Trichology published a 2013 study indicating rosemary oil could significantly improve hair thickness and growth when massaged into the scalp.
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Sun Protection: Protecting the scalp from sun exposure is important as chemotherapy can make skin more sensitive. Wearing hats or using UV-protective products can prevent further damage. The Skin Cancer Foundation notes the importance of sun protection for individuals with compromised skin integrity.
These practices, when applied consistently, can enhance hair growth and overall scalp health during the recovery process following chemotherapy.
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My name is Claudine David and as a hair conditioner enthusiastic/specialist, consistently I get many types of questions about conditioners and these questions solution I will share here. Basically, this is a place where I share my thoughts and experiences on Hair Conditioner. This website (https://conditionerhacks.com) is an outlet of my deep passion for Conditioner.
Specifically I specialize in hair conditioners. I have been working in the field of hair care for over 6 years. Basically my passion for hair care started when I was a young girl. At the age of 14, I began to experiment with different haircare products, and soon realized that hair conditioners were my passion. I’m always looking for the best and most innovative products. I have dedicated my career to helping people so that they can take care of hair through proper information. Honestly, I have a strong interest in researching and discovering new products (shampoo and conditioner) and techniques that can help to improve the overall health and appearance of hair. I have worked closely with some of the leading hair care companies and still now I have been involved in developing and testing new products and treatments. I have also worked with a number of salons and retail stores. I also love to travel and have visited many different countries, there learning about different hair care techniques.