Cradle cap

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at August 4, 2016
StartDiseasesCradle cap

Cradle cap is a common skin condition that develops on the scalp of infant babies. Cradle cap is also known as infantile seborrheic dermatitis, and it commonly appears during the first six weeks after birth. Cradle cap can look like dry skin with flakes that continuously come off, and it can also look like patches that are thick, crusty, yellowish, and oily. While it may cause alarm, cradle cap is not harmful, painful or contagious

Contents

Definition & Facts

Most often, cradle cap disappears by the time the baby is one years old, but it can last longer. In rarer cases, cradle cap continues to affect the child until puberty. Cradle cap is not itchy or aggravating for the baby. It is important to avoid scratching the flakes and trying to pick them off because this could cause the sore spots to become infected

Symptoms & Complaints

Cradle cap is easily visible on the scalp of a baby’s head. The crusty patches can cover the entire head, but it is often condensed in one area on the scalp. One might see:

  • Mild to moderate reddish spots 
  • Oily, crusty patches
  • Dry, flaky patches 

It is possible for a crusty, flaky patch to show up on eyelids, on eyebrows, and in the armpit. These areas also contain a concentrated amount of glands that produce oil.

In most cases, cradle cap is not a serious condition and home remedies help control the symptoms and improve the appearance of the baby’s scalp. It is often confused with infantile eczema; however, eczema causes itching and cradle cap does not. 

Causes 

The specific reason cradle cap develops in some babies is not known. It is commonly thought that cradle cap is caused by bacterial infections, allergic reactions, and poor hygiene. However, none of these have been shown to be a contributing factor. Doctors have several theories, and it is generally agreed that fungal infections caused by skin yeast and overactive sebaceous glands are the most likely reasons. 

Sebaceous glands are oil-producing glands that cover the scalp. Each of these glands secretes an oily substance to lubricate skin and hair. Doctors speculate that the mother’s hormones are passed to the baby before birth, and when these hormones continue to circulate in the new born baby, it causes the glands to produce too much of the substance. Because of the oily nature of the substance, it gathers and forms thick, crusty patches. Sometimes, they dry and flake off. 

Diagnosis & Tests

In most cases, a pediatrician can confirm a diagnosis with a physical examination. The location and appearance of the patches are the determining factors. In cases where it starts to spread to other parts of the body and if the patches turn into lesions that ooze, a skin biopsy may be done to rule out any other conditions that have similar symptoms to cradle cap. 

Treatment & Therapy

Cradle cap usually disappears on its own without treatment within a year. When necessary, the symptoms can be controlled with home remedies and sometimes doctors prescribe antifungal shampoo and cream. The most common home treatment involves the following:

  • Apply a pure oil on the scalp and leave it on for 15 to 20 minutes.
  • Gently massage the scalp and comb through the hair to remove all flakes that come off easily. Avoid harsh scratching to remove stubborn patches. Crusty bits will eventually come off if you do this treatment regularly.
  • Shampoo the baby’s hair with a gentle shampoo and remove all the oil. Ensure there is no oily residue left. Leaving behind any oil could block the pores.

If the condition worsens and spreads or it doesn’t disappear as the baby grows older, consulting a pediatrician for medical treatment is recommended. Doctors may prescribe medicated shampoos and creams that contain ketoconazole, salicylic acid, zinc, selenium, or coal tar.

If it becomes severe on other areas of the body and the patches become irritated, steroid creams that contain hydrocortisone can help. It is best to avoid over-the-counter anti-fungal medications without consulting a pediatrician first as these medications have side effects. The risk of applying anti-fungal and steroid medications on an infant far outweigh the benefits of the treatment because cradle cap will typically clear up on its own.

Whatever the treatment method a pediatrician provides, the instructions should be strictly followed for best results. For example, medicated shampoo needs to remain on the scalp for a specific amount of time to have the proper effect. However, overusing an anti-fungal cream or shampoo can be toxic because it can be absorbed through the baby’s skin. 

Prevention & Prophylaxis 

There is no way to prevent the onset of cradle cap. All that can be done is to is to improve the appearance of the scalp by regularly shampooing and gently combing off the crusty patches. Unless the pediatrician recommends a stronger shampoo, using a mild baby shampoo every day will help control it and reduce the size of the thick scaly patches. 

No specific gender or race is more at risk than another for cradle cap. It can be found on all infants within the first six weeks of life. It is important to understand that babies usually lose most of their hair during the first six months after birth. This is a normal process due to the resting and growing stages of hair, and it is not connected to cradle cap. Hair loss is not a normal symptom of cradle cap.