Flaky scalp in a 2-month-old baby

Cradle cap is an infant form of seborrheic dermatitis. It commonly presents with greasy or dry-looking scales that may cling to the scalp, sometimes over skin that looks pink, red or darker than the surrounding skin. It does not result from poor hygiene.

Other patterns deserve attention. A sharply defined scaly patch with broken hairs or hair loss can occur with scalp ringworm, while thick plaques may fit scalp psoriasis. A clinician can distinguish these from cradle cap by examining the scalp and any rash elsewhere.

Wash with a mild, fragrance-free baby shampoo and loosen softened scales with your fingertips or a soft baby brush. Do not scratch, pick or pull firmly because broken skin can become infected. Rinse well and stop any product that seems to increase redness.

Do not use adult dandruff shampoo, essential oils or a medicated scalp product unless a paediatric clinician recommends the exact product. Persistent or extensive scaling may need treatment chosen for an infant rather than an adult preparation.

Arrange medical review if the rash spreads beyond the scalp, becomes wet or crusted, smells unpleasant, seems painful or very itchy, or is accompanied by patchy hair loss. Seek prompt help if your baby feeds poorly, is unusually sleepy, seems unwell, or has a fever; very young babies can deteriorate quickly.

Ask whether the pattern fits cradle cap, whether skin elsewhere should be examined, and which cleanser or softening product is appropriate for your baby's age. If hair is coming away or the rash is spreading, ask whether infection needs to be ruled out.