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. For a 5-months infant with cradle cap, which is a form of seborrheic dermatitis, the treatment can be Ketoconazole Cream 2% applied to the affected area twice daily for four weeks or until clinical clearing 1.
- Key points:
- Drug: Ketoconazole Cream 2%
- Frequency: Twice daily
- Duration: Four weeks or until clinical clearing Note that cradle cap treatment should be done under the advice and supervision of a doctor.
From the Research
To treat cradle cap in a 5-month-old infant, the most effective approach is to use a gel cream containing piroctone olamine, biosaccharide gum-2, stearyl glycyrrhetinate, and zinc l-pyrrolidone carboxylate, as it has been shown to significantly reduce erythema and desquamation severity, as well as reduce the colony-forming unit count for Malassezia furfur and Staphylococcus aureus 2.
Treatment Approach
Before using any medication, gentle daily washing using a mild baby shampoo is recommended.
- Massage baby oil, mineral oil, or petroleum jelly into the scalp and leave it for 15-20 minutes to soften the scales.
- Use a soft brush or fine-toothed comb to gently remove the loosened scales while shampooing.
Medication
For more persistent cases, an over-the-counter antifungal shampoo containing 1% ketoconazole, 2% pyrithione zinc, or 2% selenium sulfide can be used twice weekly 3.
- Apply a small amount, massage gently, and rinse thoroughly.
Consultation
If the cradle cap is inflamed or doesn't improve after two weeks of home treatment, consult a pediatrician, who may recommend a mild hydrocortisone cream (0.5-1%) for inflammation or prescribe stronger medications if needed 4.
Cause and Prognosis
Cradle cap occurs because the infant's sebaceous glands are overactive due to maternal hormones still circulating in their system, producing excess oil that causes skin cells to stick together instead of shedding normally.
- Most cases resolve with consistent treatment within a few weeks.