Cradle cap (also called infantile seborrhoeic dermatitis) refers to the yellow-coloured, scaly greasy patches that are often seen on the scalps of young babies’. The scalp is the most common site for the condition but it can also develop on the baby’s neck, ears and face as well as, in the skin folds of their armpits, groin (nappy area) and behind their knees. NB. Where cradle cap appears on a part of the baby’s body, other than their scalp, the condition is called seborrhoeic dermatitis. It is a very common and completely harmless skin condition that doesn’t irritate or cause any discomfort to the baby. It tends to develop during the first few months post birth – mostly in babies under the age of eight months and will often resolve on its own after a few weeks or months. Very occasionally however, it can last for much longer – up to two years.
While cradle cap may look unsightly, it is not infectious and is not caused by poor hygiene or your baby not being looked after properly. Neither does it mean that they have developed an infection or an allergy.
The exact causes of cradle cap are unclear; however, it is believed it could be associated with overactive sebaceous glands in the skin, which secrete an oily substance called sebum. This excess sebum acts rather like a glue, so the old skin cells that your baby (and we) continually shed, stick to your baby’ scalp instead of drying and dropping off. The secretions of sebum gradually reduce however, which is why cradle cap tends to clear up on its own.
Another theory is that some babies retain some of the maternal hormones that they were exposed to while inside their mother’s uterus (womb). These hormones can stimulate the baby’s sebaceous glands so that they produce more sebum which can remain in the baby’s circulation for several weeks, even months, post birth.
It is also thought that if you have a family history of allergies such as, eczema, this can predispose your baby to developing cradle cap.
What should I be looking out for?
Cradle cap is immediately recognisable by the large greasy flakes/scales that appear on your baby’s scalp; these tend to be a yellowish or brownish colour. After a while they begin to flake away and occasionally a little of the baby’s hair may come away with them too. The area of skin that was beneath the scales will often look a little inflamed afterwards (a pink or red colour). Therefore, the signs of cradle cap to look out for are:
- Scales and flakes on the baby’s scalp
- Yellow crusts on the baby’s scalp
- Yellow or brown-coloured greasy patches on the scalp
- Inflamed areas of skin where the cradle cap was located.
Cradle cap tends to resolve spontaneously on its own without the need for any specific treatment. You should however, never be tempted to help it on its way by ‘picking’ at the cradle cap because this could damage the baby’s skin underneath and there is the risk of infection then developing. There are however, a number of steps that you can take to help prevent a build-up of the scales:
a). Washing your baby’s hair and scalp with a gentle baby shampoo can help stop the formation and build-up of flakes/scales
b). Consider washing your baby’s hair more frequently than usual (but no more than once daily) and follow by brushing your baby’s scalp with a soft baby hair brush. This can help to dislodge any loosened flakes/scales
c). Alternatively, you could massage a small amount of baby oil or natural oil (olive or almond) into your baby’s scalp at bedtime (avoid peanut or groundnut oils); this will help to soften the flakes/scales overnight. You can then use a soft baby hair brush or sponge to gently dislodge any loosened flakes/scalps; follow by washing your baby’s hair with a gentle baby shampoo
d). Where the cradle cap persists despite taking the above measures; ask your midwife, health visitor or local pharmacist for their advice. There are specialist treatment shampoos that are available over the counter from pharmacies/chemists. These are much stronger and should be used with caution, so always follow the ‘instructions for use’ in the product information and make sure your baby is not allergic to any of the ingredients. Avoid getting the shampoo into your baby’s eyes because these treatment shampoos are a lot stronger than the gentler baby shampoos.
What should I do if the condition becomes more severe?
Sometimes, despite your very best efforts, cradle cap can become more severe. Should your baby’s scalp become inflamed or infected, it is important that you contact your GP who can prescribe treatment for the condition. This tends to be a course of antibiotics (made up as a liquid medicine for your baby) or a prescription for an antifungal cream or shampoo, which is applied topically (directly to the affected area). If your baby has a very inflamed area of skin, your GP may consider prescribing them a mild steroid cream like hydrocortisone.
Longer term considerations
It is thought that babies affected by cradle cap may be more likely to develop other forms of seborrhoeic dermatitis in later life, an example being dandruff.