Cradle cap in babies: care and warning signs

Its medical name is infantile seborrheic dermatitis. Scale may look white or yellow and can sit on mildly pink skin. It is not caused by poor hygiene, and ordinary cradle cap is not contagious.

The scalp is the usual site, although similar scale can occur around the eyebrows, behind the ears or in skin folds. Cradle cap generally does not make a baby very uncomfortable. Marked itch, weeping, crusted sores or widespread inflamed skin can point to eczema, infection or another rash rather than uncomplicated cradle cap.

Hair may come away with loosened flakes, but pulling or picking scale can injure the skin. A clinician can distinguish the pattern by examining the scalp and other affected areas; routine tests are seldom needed for a typical presentation.

Wash the scalp with a mild baby shampoo, then gently loosen softened scale with a soft brush or cloth. If flakes are firmly attached, a small amount of plain emollient may help soften them before washing. Rinse it out so residue does not remain on the scalp.

Do not scratch, scrape or peel scale. Avoid adult dandruff products, essential oils and medicated creams unless a clinician specifically recommends them for the baby's age and skin. Persistent or extensive cradle cap may be treated with a prescribed antifungal or anti-inflammatory product after assessment.

Arrange medical review if the rash spreads widely, does not improve with gentle care, seems itchy or painful, or repeatedly returns with significant inflammation. Seek prompt care for fever, poor feeding, unusual sleepiness, blisters, pus, bleeding, rapidly spreading redness or skin that feels hot and swollen.

Ask whether the appearance fits cradle cap or another rash, which cleanser and emollient are suitable, how often they should be used and when to stop. If medicine is suggested, confirm the exact scalp areas, application method and signs of irritation or infection that should trigger another review.