What should you know about cradle cap solutions?

Cradle cap, also called infantile seborrheic dermatitis, produces flaky or greasy scale on the scalp. The scale may look thick even when the skin underneath is only mildly irritated. It is not a sign that the scalp is dirty. Some babies have scale around the eyebrows, ears or neck as well. The right approach depends on whether the skin is dry, inflamed, cracked or wet.

For light scale, wash gently with a mild baby cleanser and use a soft brush only after the scale has loosened. An emollient may help soften attached flakes; use a product recommended for the baby and remove loosened scale without rubbing hard. Avoid essential oils, fragranced products and picking. If the rash is inflamed or keeps returning, a clinician can decide whether topical antifungal treatment or another medicine is appropriate.

Contact a clinician when the rash is spreading, painful, markedly red, swollen, cracked or oozing. Yellow crust with discharge, bleeding, a bad smell or tender swelling needs assessment. Prompt advice is also appropriate if the baby has fever, seems ill or is feeding less. Persistent scale may resemble eczema, psoriasis or infection, so an examination can prevent unsuitable treatment.

Ask which emollient and cleanser to use, how to loosen scale safely, and whether treatment is needed for nearby skin. Ask what change should prompt a follow-up visit and whether any current product could be irritating the scalp.