What is cradle cap?

Cradle cap is the name given to the yellowish, greasy scaly patches that appear on the scalp of young babies. It is a very common, harmless condition that doesn't usually itch or cause discomfort to the baby.

Cradle cap appears most often in babies in the first 2 months and tends to last only a few weeks or months. It is uncommon in babies older than 3 months but may last up to 6 to 12 months in some babies.

What are the symptoms of cradle cap?

Cradle cap is recognisable by the large, greasy, yellow or brown scales that appear on your baby's scalp. These scales will eventually start to flake and may make the affected skin appear red. Sometimes the hair may also come away with the flakes. Cradle cap is not a serious condition and should not cause your child any problems or irritation. However, it is important not to scratch or pick at the cradle cap, in case an infection develops.

It usually starts on the scalp and can sometimes spread behind the ears. The patches may appear on other parts of your baby’s body, such as the nappy area (groin), the nose, armpits or backs of the knees. When it appears on a part of the body other than the scalp, it is called by its medical term seborrhoeic dermatitis.

What causes cradle cap?

The cause of cradle cap is not clear, although it may be linked to overactive sebaceous glands. These are glands in the skin that produce an oily substance called sebum.

It is thought that some babies keep some of their mother’s hormones in their bodies for several weeks or months after the birth. These hormones may make their glands more active, so they produce more sebum. The excess sebum causes old skin cells to stick to the scalp, instead of drying up and falling off as they would normally do.

Cradle cap is not contagious and is not caused by a lack of cleanliness. If a baby has cradle cap, it does not mean that the child has an infection or is not being looked after properly. Research has found that babies who get cradle cap often have family members with allergy-type conditions, such as asthma and eczema. A small number of babies who have cradle cap may develop other types of seborrhoeic dermatitis, such as dandruff, when they are older.

How is cradle cap treated?

Cradle cap requires no specific treatment and will clear up on its own with time. But if you’re unsure at any stage, visit a doctor who can help with the diagnosis and reassure you.

If you want to improve cradle cap faster, massage a small amount of baby oil or olive oil into the scalp at night to soften the patchy scales. In the morning, using a soft baby brush or cloth, gently remove any loose particles, and then wash the hair with a baby shampoo.

In time, the crusts will soften and should lift off easily with a cotton bud or soft baby toothbrush.

Shampoos that contain ground nut oil or peanut oil are best avoided in children under 5 years old.

Taking care with shampoos

Shampoos are available over the counter at pharmacies to loosen cradle cap. Check the patient information leaflet before you use these for any ingredients your child is allergic to, and follow the instructions carefully. You should avoid getting any in your baby’s eyes as these shampoos are stronger than baby shampoo. Speak to your pharmacist for advice. If the shampoo or other treatments worsen the condition, stop the treatments and see a doctor as your baby may have eczema.

Shampoos that contain ground nut oil or peanut oil are best avoided in children under 5 years old.

When should I see my doctor?

If the cradle cap becomes inflamed or infected, a course of antibiotics or an antifungal cream or shampoo, such as ketoconazole, may be prescribed by a doctor. A mild steroid cream such as hydrocortisone may be recommended for an inflamed rash.

It’s a good idea to see the doctor if:

• cradle cap continues after your baby is 3 months or is itchy to your baby, as this may be a sign of eczema and will need to be treated differently
• the cradle cap does not improve with treatment or your baby has signs of cradle cap on the face or body (seborrhoeic dermatitis)
• the skin under crusts becomes inflamed – this can be a sign of infection and will need different treatment
• you’re not sure it is cradle cap