Cradle cap is the common name for seborrheic dermatitis in infants. Today, we’ll break down everything parents need to know about identifying, managing and treating cradle cap.
What is cradle cap?
Cradle cap is the common name for seborrheic dermatitis when it affects babies. (In older children and adults, mild seborrheic dermatitis on the scalp is usually known as dandruff.)
Cradle cap causes thick, scaly yellow patches of rash to develop on a baby’s scalp. It usually first appears between baby’s second and sixth week of life, but then usually clears up on its own before baby reaches one year of age. (However, it can emerge anytime in baby’s first year, and sometimes lasts into baby’s second year.)
According to some research estimates, cradle cap affects around 10% of infants less than one month old, 70% of infants ages 3 months, and then lower and lower percentages as babies get older. The prevalence of cradle cap then drops to as low as 7% in toddlers 1-2 years of age. This means that cradle cap is relatively common, but is outgrown relatively quickly.
Cradle cap is not contagious. Its exact cause is unknown, but some researchers think that hormones from baby’s mother may play a part. These hormones may cause the oil glands in baby’s skin to over-produce oil, causing dead skin cells to stick to the scalp and form the crusty yellow patches.
Cradle cap is not caused by insufficient hygiene, and it is not connected with allergies.
Learn more about cradle cap from Board Certified Pediatric Dermatologist, Dr. Latanya Benjamin:
What does cradle cap look like?
How can you tell if baby has cradle cap? Here’s what cradle cap looks like:
- Crusty yellow, white, or brown patches on the scalp
- Scaly yellow, white, or brown patches on the scalp
- Patches could show up in these colors on babies with all colors of skin
- Very thick and flaky
- May look like bad dandruff
- May look like dried and hardened milk
- May look oily or waxy
- Patches could be greasy and could be dry
- Could show up as red patches with yellow flakes on top
- Could cause redness or swollen-looking areas, including near the yellow patches
- Scales often fall off after a few days
- Usually not itchy
- Usually doesn’t cause discomfort
- Could develop behind the ears as well
- Baby’s skin usually looks normal underneath the cradle cap patches
A similar-looking rash can also appear on, or spread to, other parts of baby’s body, including the:
- Eyelids/around the eyes
- Backs of knees
- Diaper area
But when a rash like this appears somewhere other than the scalp area in babies, it’s just called seborrheic dermatitis and not cradle cap.
Cradle Cap: When To Call The Doctor
Usually, cradle cap isn’t serious, but watch out for these symptoms. If any of the below symptoms appear, contact your doctor.
- Baby’s skin weeps fluid or feels hot in the cradle cap areas (these could be signs of infection)
- Baby is 1 month old or less and develops water blisters (another common sign of infection)
- Cradle cap that started on the scalp spreads to other areas of the body
- Areas cracked or bleeding (due to more severe cradle cap) appear infected
- Baby develops a persistent diaper rash
- Cradle cap becomes significantly red and irritated
- Cradle cap appears to be itchy, or appears to cause discomfort for baby
- Baby develops thrush or a fungal ear infection (this could promote the growth of bacteria)
- After you treat it, the cradle cap gets worse instead of better
- Baby’s cradle cap lasts longer than a year
Cradle Cap Vs. Atopic Dermatitis
Seborrheic dermatitis (cradle cap) is a type of eczema. However, it’s different from atopic dermatitis (the skin condition most people refer to when they say “eczema”).
Unlike atopic dermatitis, cradle cap is not closely related to food allergies. Cradle cap is not part of the atopic march, so it doesn’t put your baby at a higher risk for food allergies like atopic dermatitis does.
Cradle cap will show up as a yellow scaly rash on the scalp. Meanwhile, atopic dermatitis causes dry, itchy and inflamed skin patches that are usually red or dark brown. Atopic dermatitis rash may also be scaly, but it’s usually found on the face, arm and leg joints, elbows and knees.
And while atopic dermatitis is always itchy, cradle cap often doesn’t cause an itch.
How To Treat Cradle Cap
Cradle cap is harmless. It usually doesn’t cause discomfort in babies, unless it is severe. Plus, it usually goes away on its own between 6 and 12 months of age.
But if you’d like to treat or remove cradle cap on the scalp (especially if your little one is uncomfortable), try these safe remedies and tips:
1. Gently brush it out
Specialized brushes are available to gently brush out the cradle cap scales. But you could also use a new toothbrush with soft bristles. Follow these steps and tips if you decide to brush out cradle cap:
- Wet baby’s hair if you wish ( but you can also brush out cradle cap when baby’s hair is dry).
- Gently and slowly move the brush over the cradle cap areas. This will loosen the flakes.
- Don’t pick or scrape at the flakes, as this could make things worse.
- Only brush in one direction so you don’t scrape at the flakes.
- Gently brush through baby’s hair to remove any flakes on the hair.
- You can brush out the cradle cap as frequently as once per day.
- If brushing appears to irritate baby’s scalp, brush less frequently or try another method
2. Wash baby’s hair
Washing baby’s hair may be enough to remove most of baby’s cradle cap. Like the brushing, it’s a temporary treatment, but it’s effective when used as part of a routine.
Stick with mild baby shampoo, though, to keep baby safe.
Dandruff shampoo may contain ingredients that are unsafe for baby when absorbed through their skin, including salicylic acid. So it’s best to stay away from dandruff shampoo. (Only use dandruff shampoo if a doctor explicitly recommends a certain kind.)
Here’s how to use a mild baby shampoo routine to combat cradle cap:
- Wet baby’s hair and scalp as normal.
- Gently massage the baby shampoo all over the scalp.
- Rub the cradle cap areas gently with a baby towel, so these areas lather up. This should safely loosen the scales.
- If you wish, use a cradle cap brush or toothbrush to loosen cradle cap flakes while baby has shampoo on their scalp.
- Rinse baby’s hair and scalp thoroughly.
- Gently pat baby’s hair and scalp dry.
- Repeat this shampoo routine as often as your pediatrician recommends. (You don’t want to shampoo too much, as this may dry baby’s scalp out and worsen the cradle cap).
3. Use the oil and shampoo method
Applying a natural oil to baby’s scalp before shampooing may be helpful to remove heavier buildup of cradle cap.
Follow these steps to safely use this method. It can be used up to once per day:
- Apply pure plant oil (either 100% coconut oil, olive oil, or jojoba oil) to baby’s scalp 1-2 hours before you plan to wash their scalp and hair.
- You could also use baby oil or mineral oil for this step.
- Test a small amount of oil on the scalp first to make sure it doesn’t irritate their skin.
- Once you know it’s ok to use, then apply a thin layer of the oil to baby’s scalp, paying special attention to the scaly areas.
- Massage in the oil for about a minute.
- Be gentle, and take extra care around the soft spot of baby’s scalp if they still have one.
- Let the oil soak in for at least 15 minutes.
- Wash baby’s hair with baby shampoo, following the routine in the “wash baby’s hair” section.
- Make sure to wash off all the oil!
- If you wish, brush baby’s hair during the shampoo part of this process (as suggested above).
4. Ask your doctor about a prescription
If your baby’s cradle cap is severe, and the three routines above don’t help much with treatment, they may recommend that you apply a prescription cream (usually a hydrocortisone cream, antifungal cream, or zinc cream.) They might also prescribe a topical steroid or oral antifungal medicine, to help calm down severe inflammation.
Feel free to ask your doctor about a prescription treatment if you think your baby could benefit from one.
Be prepared when you visit the doctor with concerns about cradle cap. They will probably ask:
- How long the cradle cap has lasted
- Whether it seems like the cradle cap is uncomfortable for baby
- How, and how often, you usually wash baby’s hair
- What other cradle cap treatments you’ve tried
There are also non-prescription cradle cap creams and oils available, but you should still ask your doctor before starting to use any cradle cap treatment. It’s also best to choose a cream or oil recommended by the National Eczema Association. These types are fragrance-free and designed to be gentle on baby’s skin.
It may be frustrating when you discover that your baby has cradle cap, but remember that it usually clears up on its own within baby’s first year. In most cases, it also isn’t uncomfortable for baby. If you’re concerned about cradle cap, talk to your doctor and try one of the four treatment methods we’ve outlined above.
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