Cradle cap

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

Contents

• Cause
• How to manage it
• Complications
• What happens next?

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 and it is not caused by poor hygiene or bad parenting. It is not a health problem.

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, 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.
• Skin yeasts (Malassezia furfur) may be part of the cause.

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) liberally to the scalp and let it soak in overnight. (Some people advise not using vegetable oils because the skin yeast Malassezia can grow in the oil. This is not usually an issue.)
• The oil is washed out next morning using a baby shampoo.
• The softened scales can then be gently brushed away with a soft brush, toothbrush, comb or cloth.
• It may take several days of this 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.
• Petroleum jelly is not recommended because some babies have a reaction to it (the skin can become red and weeping). It is usually better to use oils.

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 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. (See the topic Dandruff.)

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.