Cradle cap in African American babies: what to know

Cradle cap is infantile seborrheic dermatitis, with flaky or greasy scale on the scalp. On deeper skin tones, inflammation may look brown, purple, or deeper than the surrounding skin rather than bright red. The scale may be easier to notice than color change, and it can also appear around the ears or eyebrows. Cradle cap is not caused by poor hygiene or by tightly coiled hair. Scratching and repeated picking can cause irritation and temporary darkening after inflammation settles.

Wash with a mild baby cleanser and lukewarm water, using fingertips rather than nails. A small amount of plain emollient before washing can soften attached scale. Afterward, use a soft brush only on flakes that lift easily, then rinse and dry the scalp. Avoid tight styles, scratching, fragranced products, and forceful combing over affected skin. If scale is thick or recurrent, ask a clinician whether a medicated option is suitable for the baby's age and hair-care routine.

Have the scalp assessed for oozing, pus, bleeding, swelling, worsening tenderness, open sores, or rapid spread. Seek advice if the baby seems unwell or if the skin is not improving with gentle care. A clinician can examine changes in texture and color without relying on redness alone and can separate cradle cap from infection or another inflammatory rash.

Could the color change be inflammation or irritation? Which emollient fits my baby's scalp and hair? When would topical antifungal treatment be considered, and how can it be applied without irritating the skin?