Many parents are startled to find thick, yellowish or white scales stuck to their baby’s scalp during a bath. Cradle cap, which is seborrheic dermatitis of the infant scalp, is very common and is generally not harmful to the baby.
Why It Happens
Nationwide Children’s Hospital describes cradle cap as seborrheic dermatitis on the scalp. The exact cause is not known, but many doctors think the oil glands in a baby’s scalp make too much oil, which makes dead skin cells cling to the scalp. The same source notes that cradle cap is not contagious, is not caused by poor hygiene, and is not an allergy. For that reason, parents often have nothing to feel guilty about. The patches usually do not seem to itch or bother the baby, which is another common feature.
How It Looks at Different Ages and Stages
Cradle cap tends to show up in the first weeks to months of life and often lasts a few months. Many cases fade between about 6 months and 1 year of age, though in some children it can linger until age 2 or 3. Besides the scalp, redness and yellowish scales can appear on oily areas such as the eyebrows, behind the ears, and in the creases beside the nose. Some babies also develop a red, greasy-looking rash in skin folds such as the neck or armpits, so it helps to check those areas when you see scalp flaking.
Home Care
The AAFP suggests washing the scalp gently with a mild baby shampoo. If scales are stuck firmly, you can rub a thin layer of petroleum jelly, mineral oil, or olive oil into the scalp to soften them, then lightly brush the loosened flakes away with a soft brush or soft toothbrush. Try not to pick at the crusts with fingernails, since this can break the skin and let bacteria in. Rinse the scalp well afterward so no oil is left behind, because leftover oil can trap more scales. Doing this about once a day is often enough. If a week or so of gentle care brings no change, a pediatrician can talk with you about medicated shampoos or creams.
Common Parent Misconceptions
Some parents avoid washing the head for weeks, worried that it will dry out the scalp, but the crusts can harden when they build up, and gentle washing often helps. Others reach for strong adult dandruff shampoos to clear the scales quickly, which can irritate a baby’s thin skin and are best used only after checking with a pediatrician. Some parents worry that cradle cap signals a food allergy, but the sources above state that it is not an allergy. Having cradle cap also does not mean a baby will definitely go on to develop eczema, since the two conditions look and behave differently.
Signs That Need Medical Care
Talk with your child’s doctor if the red rash spreads beyond the scalp to the face, neck, or trunk, or if your baby seems very itchy and fussy. Oozing, pus, or red swollen skin under the crusts may point to a bacterial infection and needs to be checked. If a baby younger than 3 months has a rash along with a temperature of 100.4°F (38°C) or higher, or seems limp and is feeding poorly, seek emergency care right away. This information is general guidance based on US sources; if you live in another country, please talk with your local pediatrician. This information isn’t a diagnostic tool and doesn’t replace advice from a medical professional.