What should you know about cradle cap under hair?

Hair can conceal the greasy or dry flakes of infantile seborrheic dermatitis, making the scalp seem clear until the hair is parted. Look in natural light without pulling the hair. Cradle cap may extend toward the hairline, behind the ears or onto the eyebrows. A small amount of scale is different from a tender, wet or swollen patch, which may indicate irritation, infection or another skin condition.

Separate the hair with your fingers and wash the scalp using a mild cleanser. If scale is attached, soften it with a suitable emollient before gently brushing or wiping away what lifts easily. Never use fingernails or comb forcefully through crusts. Rinse products fully so residue does not collect at the roots. If the scalp remains inflamed, a clinician can assess whether topical antifungal treatment is suitable.

Arrange an examination if hidden scale is accompanied by bleeding, pus, bad smell, pain, swelling or spreading redness. Hair that breaks, comes out in patches or becomes matted around a wet lesion also merits prompt advice. Seek urgent help when the child seems unwell or has fever. A clinician may need to inspect the scalp closely rather than judging it through the hair.

Ask how often to wash the scalp, whether an emollient is appropriate for the child’s age, and how to remove scale without pulling hair. Ask whether any hair change suggests a different diagnosis or needs testing.