What should you know about stinky cradle cap?

Cradle cap, also called infantile seborrheic dermatitis, often creates greasy or dry flakes on the scalp. Oil, shed skin and sweat can collect beneath thicker scale and produce a mild odour. The smell alone cannot identify the cause. If the skin is broken from scratching, or remains damp beneath scale, bacteria or yeast may contribute to irritation. Look at the scalp as well as noticing the odour: redness spreading beyond the flaky areas, yellow fluid, crusting, bleeding, warmth, or discomfort deserves medical advice. Cradle cap is not caused by poor hygiene, and vigorous washing can make the scalp more irritated.

Wash the scalp gently with a mild baby shampoo, rinse thoroughly, and pat it dry. A soft brush can loosen scale only when it lifts easily; do not pick, scrape, or pull attached flakes. Keep hats, bedding and brushes clean, and avoid sharing personal items. Do not put essential oils, fragranced products, adult dandruff shampoo, or medicated cream on an infant's scalp unless a clinician recommends it. A healthcare professional may suggest an emollient to soften scale or a topical antifungal treatment when the appearance and examination support that approach. Use any product exactly as directed, especially around the eyes and on broken skin.

Arrange a prompt clinical review if the odour is strong, appears suddenly, or persists after gentle cleansing, particularly when there is ooze, pus-like drainage, thick crust, increasing redness, swelling, warmth, tenderness, or marked itching. Seek urgent medical help if your baby seems unusually unwell, is difficult to wake, or has a fever. Contact a clinician if the rash spreads, affects the face or body, or does not improve with basic care. Keep the scalp dry and avoid covering it tightly while you arrange advice.

You could ask: Does the scalp look like uncomplicated cradle cap or an infection? Which cleanser or scale-softening product is suitable for my baby's age? Should I use an emollient, and how should it be removed? Would topical antifungal treatment help, and where should it not be applied? What changes should prompt an urgent call?