From the Guidelines
Cradle cap can be effectively treated at home 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. This approach is based on general pediatric guidelines and recommendations for managing cradle cap, which is a common and harmless condition in infants. The provided evidence [ 1 ] primarily discusses the treatment of tinea capitis, a fungal infection of the scalp, which is different from cradle cap. However, the principle of gentle scalp care can be applied to both conditions. For cradle cap, the focus is on removing scales and reducing oil production without causing irritation. Key steps include:
- Gently washing the baby's scalp with a mild shampoo
- Softening scales with oil (mineral, petroleum, or olive) before rinsing
- Avoiding harsh chemicals or medicated shampoos unless recommended by a pediatrician for persistent cases
- Considering medicated shampoos with 1% selenium sulfide, 2% ketoconazole, or zinc pyrithione for cases that do not improve with basic care, but under pediatric guidance
- Possibly using a mild topical steroid like hydrocortisone 1% cream for inflammation, as prescribed by a pediatrician It's essential to differentiate cradle cap from other scalp conditions, like tinea capitis, which may require antifungal treatment as outlined in the British Association of Dermatologists' guidelines [ 1 ]. For tinea capitis, treatment typically involves oral antifungal medications, such as griseofulvin or terbinafine, chosen based on the causative dermatophyte and local epidemiology [ 1 ]. Given the context of the question, the primary concern is the management of cradle cap, which does not involve antifungal therapy but rather gentle care and possibly medicated shampoos for persistent cases.
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.
- Treatment for cradle cap (seborrheic dermatitis): Ketoconazole Cream 2% can be applied to the affected area twice daily for four weeks or until clinical clearing 2.
- Alternative treatment: Selenium sulfide lotion can be used, usually two applications each week for two weeks, then less frequently as needed 3.
From the Research
Treatment Options for Cradle Cap
- Moisturizers can play a significant role in softening scale, but baby oil alone may not be sufficient 4
- Greasier emollients may not be cosmetically acceptable, and parental choice can be a key factor in successful treatment 4
- Topical, non-medicated treatments like LOYON(®) can facilitate the removal of scaling in infants and children with cradle cap without inducing spot bleedings 5
- A gel cream containing piroctone olamine, biosaccharide gum-2, stearyl glycyrrhetinate, and zinc l-pyrrolidone carboxylate can be effective in treating mild to moderate cradle cap 6
Efficacy and Safety of Treatments
- LOYON(®) was found to be well tolerated, safe, and effective in facilitating the removal of scaling in infants and children with cradle cap 5
- The gel cream tested in the 2021 study was found to reduce erythema and desquamation severity, and was well tolerated with no signs of local side effects 6
- A systematic review of interventions for infantile seborrhoeic dermatitis found that the evidence for the effectiveness and safety of studied treatments was of very low certainty 7
Commonly Used Treatments
- Emollients, shampoos, and brushing are commonly recommended or used treatments for cradle cap, but there is a lack of high-quality evidence to support their effectiveness 7
- Antifungals and steroids are also used to treat cradle cap, but further research is needed to determine their effectiveness and safety in infants and young children 7