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Cradle cap

cradle; cap; dermatitis; seborrhoeic; rash; scalp;

Cradle cap is a yellowish, patchy, greasy, scaly, crusty and sometimes smelly skin rash that occurs on the scalp of recently born babies. It is usually not itchy, and it does not bother the baby – but parents can feel distressed or embarrassed about it.

  • Cradle cap is not contagious
  • it is not caused by poor hygiene or bad parenting.
  • It is not a health problem.

Contents

Cradle cap most commonly begins sometime in the first 3 months of life. The rash can be on the forehead, around the ears, in the eyebrows or on the eyelids as well as on the top of the head. While it is most common in young babies, a few babies go on having cradle cap until they are toddlers.

It is very common, with about half of all babies affected. Most of them have mild cradle cap. Severe cradle cap is rare.

Cause 

  • Cradle cap is a type of seborrhoeic dermatitis.
  • The sebaceous glands in the skin of babies and adults make a greasy substance called sebum, which helps waterproof the skin.
  • Cradle cap happens when the glands of the scalp make too much sebum (an oil), which then traps the skin flakes which are constantly shed from the scalp forming the yellow scales.
  • The glands may make more sebum than usual because of hormones from the mother which are still present in the baby.
  • A skin fungus (Malassezia furfur) may be part of the cause.
  • Cradle cap can develop when parents only wash their baby's hair with water. Using a shampoo made for babies can wash away the skin flakes and excess sebum.

Other things that can cause a scaly rash on the scalp include eczema, psoriasis, tinea and scabies, but usually a yellowish, patchy, greasy, scaly and crusty skin rash is cradle cap.

How to manage it

Cradle cap usually goes away within a few months without treatment, but most parents prefer to try to remove the scales.

  • The most common advice is to apply oil (vegetable or mineral oil – such as olive oil, other cooking oil or baby oil) or soft paraffin (vaseline) liberally to the scalp and let it soak in overnight. (Some people advise not using vegetable oils because the fungus Malassezia can grow in the oil. This is not usually an issue.)
  • Next morning the softened scales can be gently brushed away with a soft brush, toothbrush, comb or cloth. Then wash off the scales, oil or paraffin using a baby shampoo or shampoo substitute such as sorbolene.
  • You may need to repeat this for several days before the scales are fully gone.
  • Some people advise parents to only use baby shampoo to soften the scales and that using oils is not necessary.

If these common treatments do not work ‘anti-dandruff’ shampoos may be recommended by a doctor. These usually work, but they contain ingredients which may irritate the scalp, and they can hurt if they get into eyes.

There are many products for treating cradle cap for sale. These can be expensive and are usually not needed.

Complications

If it is not done very gently, the surface of the skin may be damaged when the scales are lifted which then allows bacteria to grow – causing impetigo (school sores). See School sores (Impetigo). If this infection spreads, or your baby becomes unwell, make sure that you have your baby checked by a doctor. Antibiotics may be needed to get rid of the infection.

What happens next?

Cradle cap may go away when it is treated, but it also may come back during the next few months because the treatment only removes the scales, it does not stop the glands making too much oil.

Some babies with cradle cap may go on to have other rashes, such as eczema. Sometimes the child may develop dandruff around puberty when the sebaceous glands again make more sebum than is needed.

More information

Raising Children Network (Australia) 
http://raisingchildren.net.au/ 

Pregnancy, birth and baby 
http://www.pregnancybirthbaby.org.au 

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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