Newborn Skincare

Everything you ever wanted to know about cradle cap but were afraid to ask.

If your baby has widespread cradle cap and problems putting on weight this could represent an underlying immune system problem.

Seborrheic dermatitis, also known as cradle cap, is one of the most common rashes in newborns. It most frequently appears as redness and greasy scale on your baby’s scalp, which explains why it is called “cradle cap”. However, a lot of other areas can be affected including the face, behind the ears, and the neck. Redness is more commonly seen in the skin folds (like in the armpits or groin) and scaling is more common on the scalp. Seborrheic dermatitis very frequently can spread to the diaper region, so it’s important not to miss it if your baby has a recurrent or difficult to treat diaper rash.

Cradle cap usually presents with greasy scales on the face and scalp.

Why does my baby have cradle cap?

What causes seborrheic dermatitis is unknown. Some studies show that a type of fungus called Malassezia furfur may be involved. Interestingly, it is actually a normal inhabitant of the skin, but it can sometimes grow excessively leading to symptoms. Changes in hormones are also probably involved as well. We know that oil glands respond to changes in testosterone, and seborrheic dermatitis often occurs in areas with a lot of oil glands, like the face and scalp. Swings in testosterone during puberty is also the reason why teenagers have such bad acne. Seborrheic dermatitis can sometimes look a lot like eczema, but the lack of itch can be helpful to distinguish between them. Sometimes psoriasis can also resemble seborrheic dermatitis, but it is much less common in this age group.

Is it dangerous?

Seborrheic dermatitis in infants is usually harmless and goes away by itself, often within a few months. One study looked at babies with seborrheic dermatitis 10 years after the diagnosis and found that 85 percent of the children were disease free. About 10 percent of the children still had seborrheic dermatitis and 5 percent of children were later diagnosed with eczema. So, in the vast majority of cases it will just run its course and there is no risk to your baby’s long-term skin health.

How do I treat it?

Given that it is harmless and goes away by itself, most babies can just be watched without any type of treatment. If you are concerned about the cosmetic appearance of the scale, they can usually be removed with a soft brush after shampooing. Additionally, petroleum jelly or Aquaphor can be used to soften the scale. Some parents report a lot of success with soaking their baby’s scalp overnight in a little bit of vegetable oil and then shampooing in the morning.

If seborrheic dermatitis continues or is very severe, there are a couple of additional treatment options. Tar-containing shampoos are a great first-line treatment. Selenium sulfide shampoos are also effective, but high-quality safety data in babies is not available. Anti-fungal creams or shampoos are effective if tar-containing shampoo don’t do the trick. An over-the-counter mild steroid cream like hydrocortisone can help with some of the redness and itch. One study showed that ketoconazole cream (brand name Nizoral) and steroid creams are both effective to treat infantile seborrheic dermatitis, however ketoconazole is better at preventing it from coming back.

Moisturizing with petroleum jelly or oil will usually do the trick. If that doesn’t work, there are a couple of other effective treatments available.

Finally, although the vast majority of cases of seborrheic dermatitis go away with little or no treatment, if your baby has widespread seborrheic dermatitis along with diarrhea and problems putting on weight, you should be concerned because this could represent an underlying immune system problem. You need to see a doctor right away and get the appropriate testing.

So, that is cradle cap in a nutshell. Please leave any comments below and share this article with other parents who may be interested!

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