Cradle cap on ears: what parents should know

Cradle cap is infantile seborrheic dermatitis, a common inflammatory skin condition that can involve oily areas. Around the ears, scale may sit in the crease behind the ear, along the outer ear, or at the entrance to the ear. It can be white, yellow, or slightly greasy, with mild redness underneath. Moisture from bathing, milk, or sweat can collect in the folds and increase irritation. Cradle cap should not be pushed into the ear canal, and a rash inside the canal needs separate assessment.

Use lukewarm water and a small amount of mild, fragrance-free cleanser on the outer ear and behind it. Rinse carefully, pat every fold dry, and apply a very thin layer of plain infant moisturiser if the skin is dry; Emollient Therapy explains the role of moisturising. Keep cotton swabs, fingernails, oils with fragrance, and harsh soaps away from the ear canal. Never peel attached scale. If the rash persists or recurs, a clinician may consider whether Topical Antifungal Treatment is suitable, based on the baby's age and the exact site.

Seek medical advice if the ear is swollen, tender, hot, bleeding, cracked, or producing fluid, or if there is a bad smell. Prompt assessment is needed if the rash enters the ear canal, your baby reacts as though the ear hurts, or the baby has fever or seems unwell. A spreading rash can be eczema, irritation, or infection rather than uncomplicated cradle cap.

Is the scale limited to the outer ear, or is the ear canal involved? How should I clean behind the ear? Which moisturiser is safe, and would medicine be needed if the fold is cracked or weeping?