What should you know about age for cradle cap?

Older children and adults can develop scaly areas from seborrheic dermatitis or another skin problem, but a new scalp rash beyond infancy should not automatically be labelled cradle cap.

In a baby, cradle cap appears as greasy or dry-looking scales, commonly over the scalp. The skin beneath may look mildly pink, while the baby is generally comfortable. It is not caused by poor hygiene and it is not something a parent has done wrong.

Age helps frame the possibilities but does not establish a diagnosis. Marked itch, pain, broken skin, hair loss or a rash spreading well beyond the scalp may point to eczema, infection or another condition that deserves assessment.

Wash the scalp with a mild baby shampoo and loosen softened scales gently with a soft brush. An emollient may help soften firmly attached scale; keep it away from the eyes and wash it out as directed. Do not pick, scratch or force scales away because this can injure the skin.

If gentle care is not enough, a clinician can decide whether a medicated product is suitable for the baby's age and skin. Adult dandruff shampoos, essential oils and topical medicines should not be improvised for an infant.

Arrange medical advice if the area becomes very red, swollen, warm, painful, wet, crusted or foul-smelling, or if the baby develops fever, feeds poorly or seems unwell. These features can signal inflamed or infected skin.

A review is also sensible when scaling is extensive, repeatedly returns, causes obvious discomfort, or has not improved with gentle care. Seek prompt help for a rapidly worsening rash in a very young baby.

You might ask whether the appearance fits cradle cap, whether an emollient is appropriate, what shampoo to use, and which changes would suggest infection or eczema. If treatment is prescribed, confirm where to apply it, how often to use it and when to stop.