What is cradle cap?
Cradle cap is a common phenomenon in babies, especially in the first months after birth. There is a greasy, yellow-brown scaling that “sticks” to the scalp. Cradle cap is regarded as a baby variant of seborrhoeic eczema.
How does cradle cap develop?
How cradle cap develops is not entirely clear. There is probably an increased activity of the sebaceous glands, so that an excess of a sebum-like substance is secreted, which causes old skin cells not to be shed but to cake together. A local yeast infection (Pityrosporum/Malassezia) may also play a role, although opinions on this differ. Sometimes there is the same scaling in the eyebrows, which makes the resemblance to the seborrhoeic eczema seen in adults even greater.
Who gets it?
Cradle cap is very common and all babies can get it. It usually disappears within 6 months after birth, but sometimes it takes much longer — occasionally several years before all the scaling has gone. Adults can also develop a cradle-cap-like scaling on the scalp; in adults this is called tinea amiantacea and is likewise regarded as a variant of seborrhoeic eczema.
How is it treated?
Because cradle cap is a completely harmless phenomenon it does not need to be treated, especially as children are usually not bothered by it. If you do want to remove an excess of scales, you can rub the scalp with a mild (baby) oil to soften them. Afterwards you can gently slide off the excess scales with the edge of a piece of card. Do not use products containing salicylic acid (scale-dissolvers), because in young children this can cause poisoning. Then wash the hair with a mild shampoo.
Another baby-friendly way to remove the scales is to comb the hair out in the bath with a fine comb with not-too-sharp teeth; the scales can then be rinsed away from between the hairs. When, besides scaling, there is also eczema, the doctor may temporarily prescribe hydrocortisone cream to suppress the inflammation.
What is the outlook?
As mentioned, cradle cap ultimately disappears by itself, although this can sometimes take many months to a few years.
When to see a doctor
Cradle cap is harmless, but see your GP if the scalp becomes very red, weepy or spreads widely, if there are signs of infection such as swelling, pus or a bad smell, or if a rash also spreads to the body folds — these may need treatment beyond simple care.