In this article, we will discuss the best way to treat cradle cap in a baby. Cradle cap can be a pesky problem, but it doesn’t have to bring you and your child down. There are many ways to combat this condition. As always, remember none of this information is meant to diagnosis anything. That is your doctor’s job to do that. I have noticed that patients do not always understand everything during a doctor’s visit so this information is provided as reinforcing what your doctor stated or to provide additional information so you can have an intelligent conversation with your doctor.
What is Cradle Cap?
Cradle cap is a skin condition on the scalp that shows up as a greasy, yellow scales. It’s a form of dandruff (seborrheic dermatitis).. The idea is that this is due to over production of oil from glands on the scalp. It is generally not itchy. The name contains the word “cap” because it tends to occur in the scalp area where caps are usually worn. It can occurs in others parts of the body but when it occurs on the scalp, it is called cradle cap.
I recommend that you see your pediatrician for a definitive diagnosis. There are many subtleties only a medical professional can tease out to help diagnose conditions.
Cradle cap is not considered contagious or dangerous and it tends to resolve with children with time.
What causes cradle cap?
It is thought to be due to the hormones from the mother passing either during pregnancy of breastfeeding after birth. Also, a fungus called Malassezia is thought to be involved, so sometimes anti-fungal shampoo can be helpful.
Malassezia is normally found on skin which doesn’t cause a problem, however, when it comes in contact with oil from our skin, it will break down the oil. The breakdown products which help the fungus to thrive can also act as an irritant on skin. This ultimately results in an inflammatory response and promotes inflammation of the skin. (1)
How long does it last?
It usually occurs in the third week of life and lasts until 12 months of age, sometimes more than that. (2), (3)
How do I take care of cradle cap?
This is what I do to address this issue for my children:
- Apply oil (such as few drops of olive oil or even a teaspoon of coconut oil) to the scalp to gently massage the scalp and loosen the debris/dried oil.
- Let is sit for a 3 minutes for the scalp to soak in the oil
- Use a comb to gentle brush off the dried oil, my child really liked this
- Use a gentle shampoo to help rinse off the oil
- Pat dry the scalp
- consider applying topical steroid cream if very inflamed (discuss with your doctor first)
Cradle cap vs. infantile eczema
These two can look similar, but can be easily distinguished by a medical professional. If you have any questions, you should ask your medical doctor. In general though, eczema tends to be itchy whereas cradle cap is not.
How do you diagnose cradle cap?
Medical professional can diagnose this condition based on the appearance, patterns, location of the rash. It usually does not require a biopsy or blood test.
Can I pick at my child’s cradle cap?
Picking at cradle cap can cause it to bleed, so it’s best not to do so. Also, there’s a possibility of an infection occurring if you pick at it. Rather, a gentle bath using oil to massage and brushing off the dried oil seems to do the trick of my children. This is one of the best way to treat cradle cap.
Is cradle cap worrisome or contagious?
In general, it is not worrisome because it goes away with time and does not spread to other people by touching or being exposed to it.
Does cradle cap product an odor?
Usually not.
What other treatment options are available?
These are things to discuss with your doctor, but some options include using:
- Topical anti-fungal. It is thought that Malassezia may be involved in causing cradle cap. These are used if the above steps do not help. Speak with your doctor before trying these products.
- Anti-dandruff. Selenium sulfide and zinc pyrithione are common ingredients used in treating dandruff. They are commonly used in adults and the safety is not known for infants so speak with your doctor before trying this.
- Coal tar preparations. Help with itching and considered to be safe.
- Topical steroids– it acts as an anti-inflammatory medication and helps to reduce inflammation. Some dermatologist recommend a mild steroid cream such as hydrocortisone (0.5%). If no improvement, definitely follow up with your doctor. (4), (5)
Once again, please speak with your physician before starting these treatments.
What should I avoid?
There are home remedies including hydrogen peroxide, apple cider vinegar, or essential oil. These things are not recommended because they can harsh on your baby’s scalp and skin. Unfortunately, these home remedies are not the best way to treat cradle cap
Should Asian children with eczema be treated differently?
A 2016 paper by Cheong’s group wrote a consensus guide for Asian patients with seborrhoeic dermatitis. (6) They described that Asian skin can be more sensitive to irritants commonly found in other the counter topical products vs non-Asian. Products that contain alcohol, greasy emollients, soap, shaving cream can be very irritating and thus, gentle products should be evaluate and used instead. This paper focused on adults, so it may not be completely applicable, but it’s something to keep in mind that depending on your ethnic background, you may have to approach treatment uniquely.
I hope this guide gives you a good idea of how to manage cradle cap. If you have questions or comments, please feel free to leave a message below or you can contact me.