What’s on your baby’s head?
One day, after feeding your baby, you’re holding her and watching her sleep. You notice that there are some white, crusty areas on her head. You gently touch the areas, but she doesn’t seem to be bothered by them. What are these? What is causing them to occur? How do you remove them? Can you prevent them from coming back?
Infantile seborrheic dermatitis, or cradle cap, is a common, noncontagious skin condition that results in thick crust or scales on a baby’s scalp. They can be dry or oily. Sometimes, people confuse it with atopic dermatitis, but cradle cap isn’t itchy or painful. The exact cause isn’t known but thought to be possibly related to a couple of things, however, poor hygiene isn’t one of them. The first is hormones that pass from the mother to the baby before birth can cause too much oil (sebum) in the baby’s oil glands and hair follicles. Another likelihood is that a type of yeast, which is fungus, called malassezia grows in the sebum alongside bacteria. Symptoms of cradle cap include patchy scaling/thick crusts on the scalp, oil/dry skin covered with flaky white/yellow scales, skin flakes and mild redness to the area. Sometimes, similar looking scales appear on the infant’s eyelids, ears, nose and groin.
The good news is that cradle cap will usually go away on its own without medical treatment. The best way to manage the condition is to gently wash your baby’s head once a day with a mild baby shampoo. You can gently rub your baby’s scalp with your fingers, a washcloth or a small, soft-bristled brush before rinsing off the shampoo. A key thing to remember is to not scratch at the area. If the scales are thick or don’t loosen easily, try rubbing petroleum jelly or a few drops of mineral oil on the area and letting it soak for a few minutes to a few hours before washing your baby’s hair. Just don’t leave them in their hair for too long or it can make the cradle cap worse. Once the scales are gone, you should wash your baby’s hair every few days to prevent the buildup of new scales.
If this doesn’t work, talk to your baby’s doctor about other things that could help. They might recommend low-dose hydrocortisone cream or a shampoo with 2% antifungal ketoconazole medication. If you use either of these, make sure they don’t get into your baby’s eyes. Do not use over-the-counter cortisone products, antifungal creams or dandruff shampoos because they can be toxic to infants when absorbed through their skin.
The best prevention for cradle cap is to wash your baby’s hair every couple of days. Always use a mild baby shampoo. Only use a stronger shampoo if you’re baby’s doctor recommends it.
Cradle cap can come as a surprise to many new parents. The good news is that its easily managed and will clear up on its own in most cases. If you have any questions or concerns about cradle cap, please speak with your child’s doctor. If you would like more information, please visit the American Academy of Pediatrics cradle cap page at https://www.healthychildren.org/English/ages-stages/baby/bathing-skin-care/Pages/Cradle-Cap.aspx