From the Guidelines
To manage newborn cradle cap, gently wash your baby's scalp daily with a mild baby shampoo, then use a soft brush to loosen the scales, as there is no direct evidence from the provided studies to support alternative methods for cradle cap management. When considering the management of newborn conditions, it's essential to prioritize evidence-based practices that minimize morbidity, mortality, and improve quality of life. Although the provided study [ 1 ] focuses on neonatal epidermolysis bullosa, its recommendations for gentle skin care, such as using emollients and minimizing friction, can be broadly applied to maintaining healthy skin in newborns, including those with cradle cap. Key points to consider in managing cradle cap include:
- Gently washing the baby's scalp with a mild shampoo [ 1 ].
- Using a soft brush to loosen scales, similar to the gentle care recommended for neonates with epidermolysis bullosa [ 1 ].
- Applying a small amount of mineral oil, petroleum jelly, or baby oil to soften stubborn scales before shampooing, which aligns with the principle of using emollients to reduce skin friction and irritation [ 1 ].
- For persistent cases, considering the use of over-the-counter 1% hydrocortisone cream sparingly, or medicated shampoos with caution, underlining the importance of careful management to prevent complications [ 1 ]. Given the lack of direct evidence on cradle cap management from the provided study [ 1 ], these recommendations are based on general principles of neonatal skin care and the consensus that gentle, non-irritating practices are best for newborn skin conditions.
From the FDA Drug Label
DOSAGE & ADMINISTRATION SECTION ... Seborrheic dermatitis: Ketoconazole Cream 2% should be applied to the affected area twice daily for four weeks or until clinical clearing. The best practice for managing seborrheic dermatitis, which can cause cradle cap in newborns, is to apply Ketoconazole Cream 2% to the affected area twice daily for four weeks or until clinical clearing 2.
From the Research
Managing Newborn Cradle Cap
- Cradle cap is a benign and self-limiting variant of seborrheic dermatitis (SD) that can be distressing for parents 3, 4
- The effectiveness of commonly promoted treatments is unclear, and further research is needed to determine the best practices for managing newborn cradle cap 4
Treatment Options
- A gel cream containing piroctone olamine, biosaccharide gum-2, stearyl glycyrrhetinate, and zinc l-pyrrolidone carboxylate may be a valid option to treat mild-to-moderate forms of cradle cap, with antifungal and antibacterial properties 3
- Topical corticosteroids, such as hydrocortisone 1% lotion, may be effective in reducing the severity of cradle cap, but the evidence is limited and of very low certainty 4
- Proprietary products, such as non-steroidal cream and lactamide MEA gel, may also be effective in reducing the severity of cradle cap, but the evidence is limited and of very low certainty 4
Best Practices
- Further research is needed to determine the best practices for managing newborn cradle cap, including the use of emollients, shampoos, brushing, antifungals, and steroids 4
- Studies should report standardized and validated relevant outcome measures, including adverse events, severity, and quality of life, and should be conducted in primary care settings where the majority of cradle cap is managed 4