From the Guidelines
Cradle cap can be effectively treated by gently washing the baby's scalp daily with a mild baby shampoo, followed by softening the scales with mineral oil, petroleum jelly, or olive oil, and then carefully removing the loosened scales with a soft brush or cloth. For more persistent cases, medicated shampoos can be used. The treatment options for cradle cap include:
- Gently washing the baby's scalp daily with a mild baby shampoo
- Softening the scales with mineral oil, petroleum jelly, or olive oil
- Carefully removing the loosened scales with a soft brush or cloth
- Using medicated shampoos containing 1-2% ketoconazole, 2% selenium sulfide, or zinc pyrithione 2-3 times weekly for more persistent cases, as supported by the British Association of Dermatologists' guidelines 1 It is essential to keep medicated shampoos away from the eyes and to apply them, let them sit for a few minutes, then rinse thoroughly. If the condition doesn't improve after a week of home treatment or if it spreads beyond the scalp, it is recommended to consult a pediatrician. Hydrocortisone cream (0.5-1%) may be recommended for inflammation, used sparingly for no more than a week. Cradle cap is generally harmless, not contagious, and doesn't cause discomfort to the baby in most cases.
From the Research
Treatment for Cradle Cap
- Cradle cap, also known as seborrhoeic dermatitis, is a common skin condition that affects infants, adolescents, and adults 2.
- The mainstay of therapy for seborrheic dermatitis of the face and body is treatment with antifungal agents such as topical ketoconazole 2.
- For scalp seborrheic dermatitis, several over-the-counter shampoos are available, and patients should be directed to initiate therapy with one of these agents 2.
- Antifungal shampoos (long-term) and topical corticosteroids (short-term) can be used as second-line agents for treatment of scalp seborrheic dermatitis 2.
Topical Treatments
- Topical ketoconazole 2% treatment has been shown to be effective in reducing the risk of failed clearance of rashes compared with placebo 3.
- Ciclopirox 1% has also been shown to be effective in reducing the failed remission rate compared with placebo 3.
- Combination therapy of clobetasol propionate shampoo 0·05% and ketoconazole shampoo 2% has been shown to be effective and safe in the treatment of moderate to severe scalp seborrhoeic dermatitis 4.
Treatment Outcomes
- Ketoconazole treatment has been shown to result in a remission rate similar to that of steroids, but with fewer side effects 3.
- The treatment effect on overall quality of life remains unknown, and better outcome measures, studies of better quality, and better reporting are needed to improve the evidence base for antifungals for seborrhoeic dermatitis 3.
- Seborrhoeic dermatitis tends to relapse after treatment, and the effects of topical treatments for seborrhoeic dermatitis of the scalp and face in adults have been evaluated in several systematic reviews and studies 5.