What should you know about severe case of cradle cap?

Cradle cap, also called infantile seborrhoeic dermatitis, produces yellow, white, or brown greasy scales on an infant's scalp. It can spread to the eyebrows, behind the ears, or skin folds. The scalp may look red underneath, but babies are often otherwise well and the condition is not caused by poor care.

Thick scale can cling to the scalp and may be mistaken for infection or eczema. Weeping, crusting, marked tenderness, foul smell, fever, or a baby who seems unwell needs medical assessment rather than home removal.

Massage a small amount of a plain emollient into the scale, leave it for a short period, then loosen flakes gently with a soft baby brush and wash with a mild shampoo. Repeat gradually rather than trying to lift every scale at once. Never pick, scrape, or pull attached crusts, and keep oils away from the eyes and nose.

If the scalp is very inflamed, extensive, or not improving, a clinician may recommend a specific treatment. Topical antifungal treatment can be considered when yeast-related seborrhoeic dermatitis is suspected, but infants need product and dosing advice suited to their age.

Contact a clinician promptly for spreading redness, pus, bleeding, painful cracks, swelling, fever, poor feeding, unusual sleepiness, or a rash involving much of the body. Arrange a routine review when thick scale keeps returning, home care causes irritation, or the diagnosis is uncertain. Urgent assessment is appropriate when the baby appears seriously unwell.

Ask whether the appearance fits cradle cap, how often to use an emollient, which shampoo is suitable, and whether an antifungal is needed. Ask which signs mean the scalp is infected and how to protect the baby's eyes and sensitive skin during care.