Babies scalp red

Cradle Cap (Seborrheic Dermatitis) in Infants (for Parents)

Reviewed by: Mary L. Gavin, MD

en español Costra láctea (dermatitis seborreica) en los bebés

What Is Cradle Cap?

Cradle cap is the common term for seborrheic dermatitis (seb-eh-REE-ik dur-muh-TYE-tis) of the scalp in infants.

Seborrheic dermatitis, also called seborrhea (seb-eh-REE-uh), can show up:

on the forehead and face
behind the ears
in the diaper area, armpits, and other skin folds and creases

What Are the Signs & Symptoms of Cradle Cap (Seborrheic Dermatitis)?

Babies can develop seborrheic dermatitis when they're between 2 weeks and 12 months old. It usually starts with cradle cap. A baby with cradle cap will have slightly red scaly or crusty yellow patches on the scalp. It may also start on the face or diaper area and spread to other parts of the body.

Seborrhea looks:

red and moist in skin creases and folds (like the neck and behind the ears)
yellowish with greasy patches or crusts
scaly or flaky

Seborrheic dermatitis might look uncomfortable or irritating to the skin. But it usually isn't itchy and doesn't seem to bother infants.

What Causes Cradle Cap (Seborrheic Dermatitis)?

The exact cause of cradle cap isn't known. It's likely due to a combination of things. Too much skin oil (sebum) in the oil glands and hair follicles and a type of yeast found on the skin called Malassezia may play roles in the development of seborrheic dermatitis.

How Is Cradle Cap (Seborrheic Dermatitis) Diagnosed?

Health care professionals can diagnose cradle cap and seborrheic dermatitis by the way the skin looks and where the rash is. Babies with seborrheic dermatitis are usually well and the condition should get better on its own or with treatment.

How Is Cradle Cap (Seborrheic Dermatitis) Treated?

Cradle cap and seborrheic dermatitis in infants usually clears up on its own in weeks or months. In the meantime, you may want to loosen and remove the scales on your baby's scalp:

Wash your baby's hair once a day with mild, tear-free baby shampoo.
Gently remove scales with a soft brush or toothbrush.
If the scales don't loosen easily, apply a small amount of mineral oil or petroleum jelly to your baby's scalp. Let the oil to soak into the scales for a few minutes to several hours, if needed. Then use a soft brush or toothbrush to remove scales. Shampoo your baby's hair as usual.

If regular shampooing doesn't help, your doctor may recommend a mild steroid cream or antifungal shampoo.

For seborrhea on other parts of the body, your doctor may recommend a mild steroid or antifungal cream.

Do not use over-the-counter steroid or antifungal creams or anti-seborrhea shampoos without checking first with the doctor.

What Else Should I Know?

Sometimes seborrheic dermatitis in the diaper area or skin folds can get infected. Talk to your doctor if the rash gets worse or there are any signs of infection (the skin looks red, starts to drain fluid, or feels warm).

Cradle cap and seborrheic dermatitis in infants usually get better by 12 months of age. Seborrhea may come back around puberty as dandruff.

Reviewed by: Mary L. Gavin, MD

Date reviewed: February 2019

Seborrheic Dermatitis (Cradle Cap): Symptoms, Causes and Treatment

Nationwide Children’s Hospital

Seborrheic dermatitis (sebb oh REE ik der mah TY tis) is very common in infants and children. It appears as scaly, itchy, white, yellow or red patches. It most often appears on the scalp but can also be on the:

Face
Sides of the nose
Eyebrows
Ears
Eyelids

It can appear in body folds and creases as bright red and shiny, including:

Under the arms
Elbow crease
Behind the knees
Neck folds
Groin folds

Seborrheic dermatitis is often called cradle cap because it is common in infants. Cradle cap in infants usually improves between 8 and 12 months of age. It does not spread to others and probably does not bother your baby.

It also can happen during adolescence, which is called dandruff.

Signs and Symptoms

Common signs of seborrheic dermatitis include:

Patches of scaly skin or crusts on the scalp
Greasy skin covered with flaky white or yellow scales
Skin flakes or dandruff
Mild to moderate redness.

Causes

Seborrheic dermatitis is the result of an overgrowth of yeast on the skin. This combines with excess oil production and leads to redness and irritation on the skin. That causes the scaling and itching.

In infancy, this is often a result of the mother’s hormones in pregnancy or through breastfeeding. In adolescence, the hormones of puberty can lead to this condition.

Treatment

Treatments may include:

Topical (on the skin) steroids
Anti-fungal creams
Medicated shampoos

Medicated shampoo should be used on the scalp and problem areas. It is left on for 5 to 10 minutes then washed out.

Cradle cap in infants usually clears on its own within a few months. During that time wash your baby’s hair or scalp once a day with mild baby shampoo. Home remedies listed below can help you control cradle cap.

Gently rub your baby’s scalp with your fingers or a washcloth to loosen the crust.
Wash his or her hair once a day with mild baby shampoo.
If the patches do not loosen easily, rub petroleum jelly or a few drops of mineral oil on the scalp. Let it soak into the patches for a few minutes. Brush with a soft-bristled brush and shampoo the hair to get out the oil. If you leave the oil in your baby’s hair, the cradle cap may get worse.
Once the scaly patches are gone, wash his hair every few days to prevent scaly buildup.

When to Call the Doctor

Call your child’s doctor if:

The cradle cap does not go away after treating it at home
The patches spread to your baby’s face or body

Other Information

This condition may come and go in children. Use the medications when the rash is present.
Sometimes the medicated shampoo is used weekly to prevent flaring. Ask your child’s doctor if this treatment should be continued after the rash is gone.

Sebhorrheic Dermatitis (Cradle Cap) (PDF)

Seborrheic dermatitis in children: what to do with "milky crusts" on the head?

Symptoms of seborrheic dermatitis in children

Seborrheic dermatitis of the newborn usually develops between the ages of 2 weeks and 12 months: according to statistics, in almost half of babies, reddish or yellow scaly patches appear on the scalp. Quite often, specific crusts (gneiss) are noted - hard, hardened yellow or brown scabs or scales, which are also called "milky crusts". In older children, seborrheic dermatitis on the scalp usually presents with profuse dandruff.

In infants, seborrheic dermatitis can also sometimes start on the face or diaper area and spread to other parts of the body. So, children's seborrheic dermatitis can affect:

eyebrows, skin behind the ears, diaper area, as well as folds on the neck and under the arms.

Appearance in skin folds may be marked by a moist red rash rather than yellowish scaly patches. Therefore, despite the rather specific symptoms of seborrheic dermatitis in newborns, parents often mistake it for diaper rash (diaper dermatitis).

Seborrheic dermatitis patches do not itch or cause pain or discomfort in general to the child. As a rule, children themselves do not pay attention to this condition, although it can cause serious anxiety among parents.

Parents only need to take proper care of their baby's skin and make sure that bacterial infection does not join the spots or crusts.

How to take care of the “milky crusts” on the head?

If your child has symptoms of seborrheic dermatitis, wash the scalp daily with warm water and a small amount of baby shampoo.

Milk Crust Step by Step:

Apply plain mineral oil or petroleum jelly to baby's scalp about an hour before bathing to loosen the crusts' adhesion to the skin. When washing your hair, gently massage your scalp with shampoo for a few minutes to remove crusts. Rinse well with water and gently pat your scalp dry with a towel.

Try not to use anti-dandruff shampoo, although it works best, it can also irritate delicate skin and burn your child's eyes. In any case, before using shampoos or other products with active medicinal ingredients, it is worth discussing this with a pediatrician or dermatologist.

To soften the crusts, gently rub baby products based on mineral oils into the affected area, and then gently comb with a baby comb: this will help to remove the gneiss as gently as possible, without the risk of injury to the scalp.

As a rule, seborrheic dermatitis in children does not linger: the symptoms disappear before the child is one year old. (Although seborrheic dermatitis may return in the future after the age of puberty.)

Causes of neonatal seborrheic dermatitis

Children's seborrheic dermatitis is a condition that occurs worldwide and affects all ethnic groups.

The exact cause of neonatal seborrheic dermatitis is unknown. It is generally accepted that it is determined by a combination of factors such as hereditary predisposition, microflora features: yeast microorganisms that naturally colonize the skin, individual susceptibility to chemical and climatic irritants, hot dry air, which provokes excessive greasiness of the scalp.

Some scientists also believe that seborrheic dermatitis in infants is partly related to the hormonal status of the mother. The hypothesis is that overactive sebaceous glands on the skin of a newborn, under the influence of circulating maternal hormones, can secrete sebum more intensively, which “cements” dead skin cells so that they do not naturally exfoliate, but remain on the scalp and accumulate in crusts.

Seborrheic dermatitis on the head in children - causes, first symptoms, methods of prevention

Seborrheic dermatitis is a dermatitis that occurs at an early age, manifested by the formation of peculiar "crusts" on the skin (mainly on the scalp, although it can also be on the face, neck, ears, flexor surfaces of the limbs, back, chest and perineum) .

Causes

The exact cause of seborrheic dermatitis is unknown. It is believed that the disease develops with a combination of the following factors:

Activation of reproduction of Malassezia furfur fungi permanently living on human skin.
Hormonal imbalance in the child's body (early age - the time when the endocrine and other systems go through a period of "formation", stabilizing their functions).
Decreased immunity due to genetic disorders, frequent infectious diseases (eg, acute respiratory viral infections), malnutrition.

Symptoms

Accumulations of oily, greasy scales (crusts) on the scalp (gneiss), behind the ears, face, neck.
On the skin of the flexion surfaces, there are often clearly defined plaques of red-pink color, with fine peeling, with areas of erosion (superficial skin lesions).
Itching of the skin in the affected areas is weak or absent.
When large folds are affected (inguinal, axillary, gluteal), the appearance of a maculopapular rash (alternation of redness in the form of spots and small tubercles rising above the surface of the skin on the skin).

Prevention

Proper nutrition and a healthy lifestyle for women during pregnancy.
Timely introduction of complementary foods to an infant (for example, the introduction of vegetable purees into the diet at the 4th month, meat purees at the 6th month).
Careful hygiene of the skin of an infant (regular gentle bathing, treatment of natural folds with baby creams).

More about pediatric dermatology at the YugMed clinic

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