Toss the hats! Your baby’s crusty, scaly scalp is harmless, but it can also be hard on the eyes. Luckily, there are effective ways to treat cradle cap.
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Grown-ups get dandruff, babies get cradle cap. Both conditions are due to a harmless and common skin issue called seborrheic dermatitis, which causes rough, scaly patches and flaky skin on the scalp—not really what you want when you’re showing off your beautiful newborn to friends and family.
Unfortunately, most babies get cradle cap, and it usually appears between one and three months of age, says Michele Ramien, a paediatric dermatologist and clinical associate professor at the Alberta Children’s Hospital in Calgary. But, luckily, there are ways to treat it. Ahead, we'll dive into the reasons behind cradle cap, discuss different treatment methods, and share some tips for parents to handle this common issue in their little ones.
No one is entirely sure where cradle cap comes from, but there are some theories. “It usually occurs on areas of the body that have lots of oil glands, such as the scalp, face, upper chest and upper back,” says Ramien. “Oil glands are more active in babies because hormone levels are high during the first year of life.” Another possibility is the presence of a yeast called Malassezia, which is normally found on the skin and grows in the sebum secretions produced by oil glands.
Dr. Joel Gator, a Los Angeles-based paediatrician who specializes in parenting, wellness, and integrative medicine, states that cradle cap generally does not have identifiable risk factors. However, it is a common condition in infants up to three months old and can persist for up to 12 months.
While the specific risk factors for cradle cap (infantile seborrheic dermatitis) are not well-defined, Dr. Gator suggests that several factors may play a role in its development. One key factor is the age of the infant – cradle cap most commonly affects babies between two weeks and 12 months old, with a peak around three months of age. Additionally, the production of skin oil, or sebum, may contribute to cradle cap. “Overactive sebaceous glands in the baby's skin can lead to an excess of sebum, which can then contribute to the formation of cradle cap,” explains Dr. Gator.
Dr. Gator explains that additional factors can contribute to the development of cradle cap. One factor is yeast infections – a specific type of yeast called Malassezia can grow in the sebum (oil) on a baby's scalp, along with bacteria. This combination of yeast and bacteria may lead to the appearance of cradle cap.
Another influential factor is the baby's immune response. Some infants may have a predisposition where their immune system reacts to the presence of the Malassezia yeast and other elements, triggering the skin inflammation that is characteristic of cradle cap.
Hormonal changes can also play a role in cradle cap. Dr. Gator explains that hormones passed from the mother to the baby can stimulate excess oil production in the baby's scalp, which may contribute to the onset of cradle cap.
Cradle cap is often mistaken for eczema, another dry-skin condition. But while eczema can be itchy and irritating, most babies remain blissfully unaware that they have cradle cap. The scaly patches are white or yellow in colour and can be dry or greasy. “Cradle cap isn’t contagious or associated with poor hygiene,” says Julia Orkin, a paediatrician at the Hospital for Sick Children in Toronto and chair of the Canadian Paediatric Society’s Community Paediatrics Committee. “It’s primarily a cosmetic concern, and it usually goes away on its own within a couple of weeks to a few months.”
That said, if your baby’s skin becomes red and inflamed or involves more than the scalp or if your child is unwell or has a fever, Orkin says it’s time to check with your healthcare provider. “Cradle cap shouldn’t bleed easily or be extremely itchy,” says Ramien. “A baby shouldn’t be unwell from cradle cap. If symptoms persist and there seems to be no improvement with treatment, I would suggest seeing a doctor because—very rarely—severe, treatment-resistant cradle cap can be associated with immune system problems.”
Cradle cap is usually diagnosed based on a physical examination and the appearance of the skin by the parent or pediatrician, says Dr. Gator. “Health care providers look for the characteristic scales and crusts on the scalp, which are often greasy or oily and can appear as yellow or brown patches,” he explains to Today’s Parent. “It’s typically distinguished from other conditions like eczema or psoriasis by its appearance and location on the body.”
Treating cradle cap can be very rewarding, says Ramien. “Often, parents just assume that they have to wait for it to go away on its own, but mild cradle cap can completely resolve on its own within a few days of treatment,” she says.
Shampooing your baby’s scalp daily can help treat and prevent cradle cap. “Use gentle baby shampoo with as little fragrance as possible because it’s less likely to cause skin sensitivities later on,” says Ramien.
Baby or mineral oil can help soften the scales on your baby’s skin, says Orkin. “Apply a very small amount of oil—just a couple of drops—and massage it directly into the scales,” says Orkin. Ramien recommends avoiding olive oil, regardless of what you read on the internet. “Olive oil seems to detract from the skin’s natural barrier function,” she says. Though most research supports the use of baby or mineral oil to treat cradle cap, “coconut and sunflower oils are better options for patients who want to use a natural oil, says Ramien.
As for essential oils, such as geranium and tea tree oils, it’s best to skip those altogether. “I wouldn’t recommend using these oils in babies with cradle cap because we know the condition can be a predictor of eczema and those with eczema are more likely to become allergic to highly scented products, such as geranium and tea tree oils,” says Ramien.
To remove scale build-up, gently brush or massage your baby’s scalp with a baby brush or comb.“It’s a good idea to brush out the scales, roughly 30 to 60 minutes after you’ve applied shampoo or oil to give it time to sink in, says Orkin. Avoid scratching or picking at the scales because it can make the condition worse.
Occasionally, Ramien will prescribe an antifungal shampoo (ketoconazole) to help treat the yeast and, very rarely, an anti-inflammatory cream or oil that contains a mild topical corticosteroid (like hydrocortisone), combined with an anti-yeast cream. But, she says, it’s better not to overtreat the condition. “If your baby isn’t bothered by the cradle cap, it will usually go away on its own by eight to 12 months of age,” says Ramien.
According to Dr. Gator, consistent care of the scalp is key to preventing cradle cap from coming back. This involves using a soft shampoo to wash away extra oil from your baby's scalp and soft brushes to help remove the scales.
Regularly following a scalp care routine and watching for any signs of skin irritation can also assist in managing and stopping cradle cap from reoccurring.However, if the condition persists or is severe, Dr. Gator suggests getting in touch with a healthcare professional, as they may prescribe particular treatments or recommend special shampoos
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