Biofilms are essentially thick tenacious snot that protects bacteria and fungi from the effects of antimicrobials and irrigants. It has been hypothesized that the use of 1% Johnsons baby shampoo (1/2 tsp in 1 NeilMed Sinus Rinse bottle bid) helps emulsify the biofilms and allows for irrigation and removal of the offending organisms. It is essentially a detergent or surfactant that allows for the dissolution of the thick ropy mucous and crusting.