By Sydney LoneyUpdated May 16, 2022
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.
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.
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.”
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.