From the Guidelines
Cradle cap, also known as seborrhoeic dermatitis, is the rash infants get due to increased oil in the skin. This condition is characterized by yellowish, greasy, scaly patches on the scalp and sometimes other areas like the face, ears, and diaper area. It occurs when the oil-producing sebaceous glands in a baby's skin become overactive, leading to an accumulation of skin cells that don't shed normally. To treat cradle cap, gently wash your baby's scalp daily with a mild baby shampoo, then use a soft brush to loosen the scales. For more persistent cases, applying a small amount of mineral oil, petroleum jelly, or baby oil to the scalp about 15 minutes before shampooing can help soften the scales. If these home remedies don't work, your pediatrician might recommend a medicated shampoo containing 2% ketoconazole, low-strength hydrocortisone cream (0.5-1%), or selenium sulfide 1. Some studies have also explored the use of topical coal tar in the treatment of seborrheic dermatitis, although its use in infants is not well-studied 1. Cradle cap typically resolves on its own within a few weeks or months as the baby's sebaceous glands mature and reduce oil production, though it may occasionally recur until the child reaches toddlerhood. Key considerations for treatment include:
- Gentle skin care to avoid irritating the skin
- Avoiding harsh shampoos or soaps
- Using soft brushes to loosen scales
- Applying topical treatments as recommended by a pediatrician It's essential to differentiate cradle cap from other skin conditions, such as atopic dermatitis, which may require different treatment approaches 1.
From the FDA Drug Label
Seborrheic dermatitis: Ketoconazole Cream 2% should be applied to the affected area twice daily for four weeks or until clinical clearing. The rash in infants caused by increased oil in the skin is seborrhoeic dermatitis.
- It is also known as seborrheic dermatitis.
- The treatment for seborrheic dermatitis using Ketoconazole Cream 2% is applied twice daily for four weeks or until clinical clearing 2.
From the Research
Seborrhoeic Dermatitis in Infants
The rash in infants caused by increased oil in the skin is known as seborrhoeic dermatitis. This condition is characterized by:
- Yellowish, scaly patches on the scalp, also known as "cradle cap" 3
- Little or no itching 4
- Typical skin symptoms, distribution, and evolution 4
Causes and Triggers
The exact cause of seborrhoeic dermatitis in infants is still debated, but it is thought to be related to:
- Excessive sebaceous gland activity from maternal hormones 3
- Cutaneous microbiome alterations 3
- Fungal colonization by Malassezia spp. 3, 5
- Candida albicans may also play a role in the pathogenesis of infantile seborrhoeic dermatitis 4
Treatment and Management
Treatment for seborrhoeic dermatitis in infants typically involves:
- Shampooing and removing scales with a soft brush after applying mineral oil or petrolatum 6
- Topical antifungal agents, such as ketoconazole cream 5, 7
- Topical corticosteroids, such as hydrocortisone cream 7
- Baby shampoos enriched with emollient agents and vegetable oils may also be effective in managing "cradle cap" 3