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Cradle Cap

Naturally, crusting, redness and yellow scaling rashes on a newborn baby’s scalp can cause worry. Fortunately there’s no need for alarm. This is most likely a condition called cradle cap. Also referred to as infantile seborrheic dermatitis, cradle cap is a common condition among newborn babies and infants that’s harmless and not indicative of other medical problems. Up to half of all babies are affected by the condition during the first three months of life.

What Causes It?

Glands on the skin and scalp called sebaceous glands produce a thick, sticky substance called sebum, which helps to protect the skin from moisture loss. When these glands produce too much sticky sebum, skin cells become trapped in it and aren’t sloughed off normally and pores become clogged with dead skin cells. This leads to the crusty rash, redness and scaling that is typically seen with cradle cap. Poor skin hygiene is not believed to be a cause of cradle cap.

What causes the sebaceous glands to produce too much sebum? Hormones from mom are still circulating in a young baby’s bloodstream for a few weeks after birth. Experts believe these hormones stimulate the sebaceous glands to over-produce sebum and clog the hair follicles. Cradle cap is more common in families with allergic conditions such as asthma and eczema. In some cases, the affected areas can become infected with bacteria, causing redness, swelling and blisters that drain fluid. Yeast growing in the excess sebum may also be a contributing factor for cradle cap.

There’s some thought that cradle cap may be related to a deficiency of the B-vitamin biotin, but there’s not enough evidence to support supplementing with biotin.

Cradle cap isn’t a cause for alarm, and it can usually be treated at home as long as the areas aren’t infected. The scaly rash usually resolves on its own in six months or less, although some cases can last up to a year. The symptoms will resolve over time without treatment and the areas are typically not painful or itchy, but many new mothers want to treat the areas for cosmetic reasons or their own reassurance. In some cases, the rash and scaling will spread to other parts of the body, particularly around the eyes, eyebrows or behind the ears. Some doctors may recommend a mild hydrocortisone cream.

The best way to treat the affected areas is to rub the scales and crusts with mineral oil to soften and loosen them up. Use a soft toothbrush to massage the scales to gently remove them. Follow up by shampooing baby’s head with a mild baby shampoo. If the areas become inflamed, some doctors will recommend a dandruff or anti-fungal shampoo. If the areas are infected, they may prescribe an antibiotic.

Talk to your baby’s doctor before using medicated shampoos since some of the ingredients can be irritating to a baby’s eyes. The areas are not typically itchy, although some babies pick at the scales and cause irritation that can lead to itching. If this is the case, some doctors may recommend a mild hydrocortisone cream. Shampooing every other day may help with the scaling, but always use a mild shampoo to avoid irritating the scalp.

Cradle cap is a harmless and common condition that goes away within the first year of life, but babies who have this condition may be at greater risk for seborrheic dermatitis or dandruff later in life.

The Bottom Line?

Infantile seborrheic dermatitis or cradle cap is a benign condition that’s not harmful or irritating to a baby. It’s one of the most common conditions seen in newborn babies and babies under three months of age. It usually resolves on its own within six months to a year, although babies who have it may be more susceptible to seborrheic dermatitis or dandruff later in life. Cradle cap is also more common in families where allergies are common, so it may be a marker for an increased risk of allergies later on.

Even though treatment isn’t necessary in most cases, gently removing the scales and shampooing with a mild shampoo every other day can markedly improve the appearance of baby’s scalp – and that’s a good thing for new moms who want to show off the new member of their family.