Seborrheic dermatitis in infants or commonly known as cradle cap is rough, scaly patches of skin on newborn’s scalp. Usually it is a harmless condition and clears on its own in few months.
It’s a relatively common condition in newborns and children as old as 3 years and causes thick white or yellow scales on the scalp.Sometimes, seborrheic dermatitis can even occur on the eyebrows, eyelids, ears, crease of the nose, back of the neck, diaper area, or armpits.
The exact cause of cradle cap is unknown, although it is believed to be due to an overproduction of skin oil (sebum) in the oil glands and hair follicles. Also a type of fungus called malassezia can grow in the sebum along with bacteria.
Seborrhea happens most often in babies and teenagers. In both of these times in a person’s life, hormone levels are high, which also might play a role in the condition.
Certain factors — like weather extremes, oily skin, problems with the immune system, stress, and other skin disorders can make it more susceptible to cradle cap.
Affected areas will usually have one or more of these symptoms:
- thick plaques or crusts (especially on the scalp, but sometimes on the ears, eyelids, eyebrows, nose, neck, groin, or armpits)
- greasy or oily patches of skin, often covered with white or yellow scales
- skin flakes (dandruff)
In a very few cases, babies with cradle cap will have skin that is a little red or itchy, and some might even have hair loss, though the hair usually grows back after the cradle cap is gone.
When to see a doctor
In most cases, cradle cap can be easily identified at home but you should see the doctor if
- you find cradle cap for the first time on your baby’s scalp
- your child has spots in places where he or she doesn’t have hair
- you’ve tried home treatments without success
- the rash gets worse or covers large parts of the body
- the rash is causing hair loss or becomes itchy
- the affected skin becomes firm and red, starts to drain fluid, or feels warm, which could be signs of an infection
- your child has a weak immune system
- your child has seborrhea and is having trouble gaining weight
While most cases of cradle cap does no’t require any treatment, you may want to loosen and remove the scales on your baby’s scalp. This usually can be done by gently massaging your baby’s scalp with and washing your baby’s hair once a day with mild baby shampoo while scales are present.
If regular shampooing doesn’t help, ask your doctor about nonprescription medicated or dandruff shampoos. These shampoos contain ingredients such as salicylic acid, coal tar, zinc, selenium, and ketoconazole that can help treat dryness and flaking.
Rub a little shampoo into your child’s scalp and let it soak in for at least 2 minutes. Then wash the shampoo out and repeat the process one more time. You might need to do this daily or twice weekly at first, but after the cradle cap is under control, you may only have to use medicated shampoos once a month.
Seborrheic dermatitis is self limiting, easy to diagnose and treatment is simple. For stubborn scaling and redness, your pediatrician may also recommend drugs such as cortisone lotions or creams. Call your pediatrician if the scaling and redness gets worse after home care, forms crusts, drains liquid, or becomes very red and painful.
Dr Prerna Gaur