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Reviewed By:
Robert Daigneault, M.D
Rafiu Ariganjoye, M.D., MBA, FAAP
Cradle cap is a very common type of dermatitis (skin rash) that appears on the scalp of infants. It usually occurs within the first month of life and goes away within weeks or months. Cradle cap is uncommon after the first year of life. Rarely, it can affect children up to three years of age.
Rarely uncomfortable or itchy for a child, cradle cap can produce yellow, crusty patches of skin on the scalp. This may worry parents and other caregivers, although cradle cap is a harmless and temporary skin condition. It is not an infection and is not contagious, although it may recur in some infants. If affected areas of the scalp are scratched, it may cause inflammation or a tear in the skin of the scalp that can lead to bleeding or infection.
There are many different types of skin rashes that may occur in young children. The type that causes cradle cap is called seborrheic dermatitis. This type of dermatitis involves the top layer of skin (epidermis). Seborrheic dermatitis may affect other areas of the body, typically oily areas such as the eyelids, ears, nose area and groin. When it affects just the scalp of teens and adults, it is commonly called dandruff. When it affects just the scalp of infants, it is called cradle cap.
Cradle cap is accompanied by excess secretion by the sebaceous glands (oil-producing glands) of the scalp. Excess oil produced by these glands can help create the buildup of dead skill cells on the scalp – producing the flaky, crusty appearance of cradle cap.
Cradle cap is different from the following skin conditions that may also affect small children:
• Eczema. Inflammatory skin condition that usually causes itching. The skin may also appear dry and scaly.
o Atopic dermatitis. Causes red, scaly and swollen skin at the elbows and knees as well as in other areas of the body. Atopic dermatitis is most often caused by allergies. It may be called infantile eczema when it occurs in infants.
o Contact dermatitis. Skin inflammation and rash that is most often caused by irritants. This may include a baby’s own saliva, bubble bath, strong soap or scratchy woolen fibers. Irritation occurs in the area affected by the irritant.
• Diaper rash. A type of contact dermatitis caused by the irritation of diapers and urine or feces against the skin.
• Psoriasis. A genetic disease that causes portions of the skin to be scaly, inflamed and itchy. It can occur on various places of the body, including the scalp, elbows and knees.
• Heat rash. A rash that may occur on the face, chest and arms as the result of overdressing during hot temperatures.
• Milia. A cluster of tiny pearly white or pale yellowish pimples that appears on the nose and chin. Milia is common in newborns, usually appearing during the first few days of life.
• Infant acne. Acne that appears on the cheeks, chin and forehead of infants. It usually develops at three weeks to four weeks of age.
• Yeast infections. Infection that causes a rash in the genital area. It occurs in infants due to the growth of microorganisms that thrive in warm, moist environments such as diapers. It can affect boys and girls.
Treatment and prevention of cradle cap
Cradle cap in infants cannot be prevented. Most cases of cradle cap resolve without any type of treatment. However, there are things parents can do to help cradle cap clear up faster. These include:
Gently brush scalp with soft brush (e.g., toothbrush) or fingers. This loosens the flaky skin and helps to improve circulation in the area. This should be done before shampooing, which will help clean dead skin cells from the area. Parents should be careful not to rub too hard – this may cause tears in the skin of the scalp, which can lead to bleeding or infection.
If crust on scalp is hard, try oil. Applying mineral oil, baby oil or petroleum jelly to the scalp before shampooing can help soften crusty patches of skin on the scalp. Apply oil or jelly to the scalp, then wrap with warm, wet cloths for one hour prior to shampooing. If the cloths get cold, rewrap with warm cloths (since cold items on the head can reduce a baby’s temperature). Do not apply oil to the scalp after shampooing, since it may help flakes stick to the scalp, worsening the condition.
Daily shampoos. Gently shampoo an infant’s scalp with a mild soap (e.g., non-medicated baby shampoo) every day. Parents may wish to reduce shampooing to twice a week after skin flakes are no longer present on the scalp. All soap should be rinsed off the scalp before drying. Parents should not shampoo an infant’s scalp more than once a day – too much cleaning of the area may cause the skin to dry out, worsening the condition.
Brush hair with clean, soft brush. This should be done after each shampoo and several times throughout the day.
Parents should consult a pediatrician if the problem persists, symptoms worsen or other areas of the body become affected.
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