What is Cradle Cap?
Cradle cap is a relatively innocent inflammatory skin condition causing rough, scaly patches on the top of an infant’s head.
Cradle cap is the common term used when seborrheic dermatitis appears on an infant’s scalp. This rash is also commonly known as dandruff in older children and adults. (1)
This inflammation is not contagious and will generally disappear on its own. It is a prevalent condition, usually occurring in the first few weeks of life. However, a child may remain at risk until three years of age.
Symptoms
It is not unusual, especially for new parents, to feel worried when a skin rash appears on their newborn. Fortunately, cradle cap is typically harmless and is not a result of bad hygiene.
The exact causes remain unknown. But some experts believe that hormonal changes during birth give rise to over productive oil glands. This leads to a buildup of oil on the scalp’s surface. This in turn interferes with skin shedding, causing dandruff. (2)
Another theory points towards a yeast (fungus) called malassezia. This can grow in the sebaceous (oil) glands alongside bacteria,and may also influence the development of cradle cap. (3)
Factors such as stress, extreme weather changes or a weakened immune system may increase the likelihood of developing cradle cap.
The appearance of cradle cap is different on every baby and child. For some, it may appear as one patch, while for others it might spread across the scalp.
Sometimes it can spread to the eyebrows and eyelids. Some might even encounter it in the crease of the nose and back of the neck and ears. Infants usually don’t seem bothered by the rash. However, older babies may scratch it which can lead to infection. (4)
Some of the symptoms may include:
Thick Crust
The skin in the affected area is likely to begin to thicken. It can appear as one spot, or it may be widespread. The thick patches might look dry and crusty. (5)
Greasy or Oily Skin
The appearance of the baby’s scalp is likely to be very oily. Cradle cap is assumed to be caused by overproduction of oil in the glands and hair follicles. A greasy texture may therefore seem like an obvious indicator. (6)
Yellow, brown or white scales, depending on skin tone, are likely to develop and may cover the greasy patches.
Dandruff
Cradle cap will generally cause the skin to form flakes. These may break off and appear as dandruff. (7)
Redness
In some babies, the affected skin may appear red and itchy. This is, however, more prevalent among infants with sensitive skin. Those suffering from another skin condition such as eczema are also more prone to develop a more irritable cradle cap. (8)
Hair Loss
Hair loss might be a distressing symptom for some parents. It is not an inevitable side effect, and won’t affect everyone with cradle cap. Fortunately, hair will usually return once the cradle cap subsides and skin returns to normal. (9)
Infection
Cradle cap is by nature a non-infectious skin condition. It will typically cause more distress for the parents than the baby.
However, when cradle cap affects older children, they may get an urge to scratch or pick at the patches. This could lead to infection as the skin is already vulnerable. (10)
If an infection has occurred, the area will most likely appear red and warm to the touch. It may even crack and ooze clear or yellowish fluids.
Infection is also more likely to take place if the child has a weakened immune system or eczema.
Stages
Exact causes for cradle cap are unknown. It is generally self-limited and runs its course before the age of three.
Cradle cap is an infant form of dandruff, which is generally evaluated as either primary or secondary stage. This classification refers to dandruff in general, and is not specific to cradle cap.
Staging for dandruff depends on whether the condition was caused by a microorganism (fungus, bacteria) or another non-microbial disease. This is to determine the course of treatment. (11)
Stage #1 (Primary)
If a patient is diagnosed to be in stage one, it means that the dandruff was caused by specific conditions or other factors which were not produced by a bacteria or fungus.
This stage determines the non-bacteria causes of dandruff and is divided into two possible reasons.
#1
The patient has several predisposing factors which makes him/her susceptible to the development of dandruff. This could be a preexisting condition for example eczema or allergies causing the skin to be extra sensitive.
#2
In contrary to the latter, this patient will have multiple factors which don’t necessarily have any underlying or apparent causes or triggers of dandruff.
Stage #2 (Secondary)
Patients diagnosed with a secondary cause, have contracted a fungus or bacteria which is causing dandruff.
It includes two possible causes of microbial origin.
#1
The patient’s dandruff was caused by multiple bacteria or fungus which were present on the scalp. Generally in these cases, the culprit is usually the malassezia yeast which has multiplied and caused a dandruff-like rash.
#2
The patient will usually have a compromised or an impaired immune system, which causes a differentiated response to foreign bodies.
Treatment
Cradle cap is many times fairly easy to recognize and is not always in need of a medical diagnosis. (12)
If you are unsure, if the area seems infected or home treatments don’t work, consulting a pediatrician is advised.
Treatment for cradle cap can include:
Shampooing
If your baby has cradle cap, you may be able to leave it and let it run its course. However, you can also loosen the scales to speed up the process. (13)
Washing your baby’s hair once a day with a mild shampoo followed by massaging and soft brushing the head may remove and loosen the scaly skin.
If the skin seems resistant, there are medicated shampoos containing sulfur and salicylic acid which can be used. These are a little harder on the surface, so a pediatrician should be consulted.
Oil and Ointments
Petroleum jelly or ointments have proven to be beneficial when treating cradle cap. Mineral oil may also help loosen the scales. However, it should be washed out afterward as it can trigger a buildup and worsen the rash. (14)
Further Treatment
If the rash remains persistent, your doctor might prescribe a cortisone cream or lotion. This may also be applied if the outbreak is found in other parts of the body. (15)
If the area seems to be infected, your doctor is likely to prescribe antibiotics to clear out the infection. (16)
FAQ
What is cradle cap? Cradle cap is a non-infectious skin condition affecting the scalp of children under the age of three.
What are the signs of cradle cap? Symptoms may include thick, crusty or flaky skin. The scalp will usually appear oily or greasy, with white, brown or yellow scales. If infection occurs, the area is likely to become red and warm to the touch. Some children may experience slight hair loss, but this will usually grow back again.
How do you develop cradle cap? Doctors remain uncertain of the exact causes. However, it is believed to emerge due to an overproduction of oil or yeast in the scalp. Certain factors seem to provoke this hyperactivity, such as extreme weather, oily or sensitive skin, weakened immune system, and stress. (17)
How are you diagnosed for cradle cap? Cradle cap is relatively easy to recognize. It is typically a very harmless childhood rash, so a medical diagnosis is not always necessary. However, if it seems to be infected, it’s important to seek medical advice. A doctor can usually make a diagnosis by merely looking at the area. (18)
What is the best treatment of cradle cap? If your baby has cradle cap you could leave it be, and it will generally resolve on its own. Otherwise, washing your baby’s hair once every day with a mild shampoo, followed by soft brushing or massaging, may help. If it’s infected, your doctor will likely prescribe antibiotics. (19)
What are the long term complications of cradle cap? Cradle cap will usually run its course before the age of three, and will generally not leave any scars or damage behind.
Is cradle cap considered a disability? No, cradle cap will not affect either the physical or mental development of a child.
Is there a cure for cradle cap? Yes, it is generally easy to cure with treatment.
Is cradle cap life threatening? Cradle cap has not shown to be a life threatening condition.
Summary
Cradle cap is a widespread, non-infectious skin condition affecting the scalp. It is generally seen in children under the age of one.
It is not a result of bad hygiene, rather an overproduction of oil, which gives the scalp a greasy appearance.
This condition may alarm new parents, as the skin on the scalp will begin to thicken and appear crusty. However, it is very treatable and usually not a cause for concern.