How is cradle cap different in children?

In children, cradle cap usually appears as greasy or dry scales on the scalp and is often less itchy than other childhood rashes. It can look prominent while the child otherwise seems well.

Cradle cap, also called infantile seborrheic dermatitis, commonly affects the scalp and may extend to the eyebrows, behind the ears or skin folds. The scale can be yellowish, white or brown and may sit over mildly pink skin. It is not caused by poor hygiene. Unlike eczema, it may cause little itching, although children can have more than one skin condition at the same time.

Wash the scalp with a mild children’s shampoo, then soften scale with a small amount of plain emollient before gently brushing with a soft brush. Do not pick, scratch or force off attached flakes, because this can injure the skin. Rinse oils thoroughly and stop any product that causes redness. A clinician can recommend a medicated product when home care does not settle the scale.

Arrange a medical review if the scalp is very red, swollen, painful, oozing, foul-smelling or bleeding, or if the child is unusually unsettled. Seek prompt care for fever with a rapidly spreading rash, facial swelling or breathing difficulty. Ask for an assessment when the rash spreads widely or does not improve with gentle care, since infection or another dermatitis may need different treatment.

Ask whether the scale fits cradle cap, which cleanser or treatment is suitable for the child’s age, and how long to try it. Clarify how to apply it, what irritation looks like and when the scalp should be rechecked.