Brushing out cradle cap: what parents should know

Cradle cap, also called infantile seborrheic dermatitis, causes greasy or dry flakes and yellowish crusts on a baby's scalp. It is usually not caused by poor hygiene and may not bother the baby. Scales can cling to the hair and skin, so forceful brushing may cause tiny breaks, bleeding, or irritation.

Wash your hands, then apply a small amount of a plain emollient to the scalp and leave it briefly to soften the scale. Use a soft baby brush or fine-toothed comb with very light pressure, moving in the direction of hair growth. Remove only loose flakes, then wash away the residue with a mild baby shampoo. Do not use fingernails, scrape crusts, or pull attached hair. If the skin looks raw, stop brushing and ask a clinician about suitable emollient therapy.

Arrange medical advice if the scalp is very red, swollen, bleeding, oozing, foul-smelling, or painful, or if the rash spreads beyond the scalp. Seek prompt help if your baby seems unwell, feeds poorly, or develops a fever. Persistent or severe scaling may need an examination and clinician-directed treatment, such as topical antifungal treatment.

Ask whether the appearance fits cradle cap, which emollient is suitable for your baby's age, and when brushing should stop. You can also ask how to tell irritation or infection from ordinary scaling.