Cradle Cap in infants

Cradle Cap in infants

What is Cradle Cap?

Cradle cap is a common issue seen in neonates and infants. The most common manifestation is in form of an area of rough scabbing over the scalp of the head, something similar to dandruff.

It is so named because of the peculiar position where a cap would normally sit.It is also called by other names such as Infantile Seborrhoeic dermatitis, pityriasis capitis , honeycomb disease, milk crust, etc. The incidence in the literature ranges from 10 % at 1 month, peaking at 60-70% at 3 months of age, and less than 10 % at 1 year of life.

How does cradle cap present?

It can have variable presentation as described below 

  • greasy white or yellow scales which later on may flake as well  
  • Change in color of the skin on the scalp 
  • Hair loss: it may present with temporary hair loss in patches  
  • Other parts of the body. Aside from the head, it can also show up the face, behind the ears, the diaper area, and the armpits

What are the causes of cradle caps?

It is believed to be caused by overactivity of sebaceous glands and or combination with fungal infection. Overactive sebaceous glands may produce too many secretions(sebum), and this could prevent the old skin cells from drying and falling off the scalp. Instead, they stick to the scalp. This may be due to the impact of maternal hormones .some association has also been seen with a family history of eczema and asthma.

What can be done for the cradle cap?

1 Brushing :

Gently brushing your baby’s scalp with a soft brush is a good way to get rid of some flakes, even a soft toothbrush may be used for the same 

Salient practical tips :

  • Moving in one direction, slowly brush the affected area of the scalp to loosen flakes.
  • Continue brushing through the hair to remove flakes from each hair strand.
  • You can do this on wet or dry hair.

Note:  If the scalp becomes red or agitated, brushless often. 

  1. Hydrating  the scalp:

Hydrating the scalp with oil is an effective way of getting rid of flakes, and some people feel it nourishes the scalp underneath. Any plant source oil like olive, coconut, jojoba, or almond oil can be used. Always try it with a small amount for the first time to check for any irritation and once a day application is enough. 

  • Apply a thin layer of oil to the scalp via gentle massage 
  • Leave the oil to soak in for about 15 minutes.
  • Wash the oil out with gentle baby shampoo.
  1. Wash baby’s hair:

Maintaining good hair hygiene is a good way to both prevent and manage cradle caps. Baby shampoo may be enough to help treat the cradle cap. Don’t use any medicated shampoo without your pediatrician’s advice. Shampooing on alternate days is enough. 

  • Gently wet the hair and scalp with lukewarm water.
  • Apply shampoo into the scalp and massage it gently for a couple of minutes.
  • Rinse the baby’s hair to remove all of the shampoos.
  1. Apply prescription creams:

In some cases, your pediatrician may prescribe some medication for a local application like zinc, steroids, and antifungals. these should only be used as per medical advice.

When to seek help?

A cradle cap is usually not urgent but it’s worth mentioning to your doctor at your child’s next check-up. If the skin looks very red, infected, or agitated, call your doctor. 

Following are the red flag signs which solicit immediate medical attention :

  • Areas start to go red
  • Patches start to look irritated
  • The affected area spreads to the face or starts to appear on the body
  • Diaper rash occurs
  • The infant develops a fungal ear infection
  • Signs of thrush appear.


By Dr. Jaskaran Singh Sawhney

Consultant Neonatology

Motherhood Chaitanya Hospital,Chandigarh

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