September, 27th 2011
Cradle cap—or infantile seborrheic dermatitis—is a common, completely harmless infant skin condition. But no, it certainly doesn't look harmless. The oily, yellow and/or white flakes will have passersby discretely throwing up in their mouths before saying "Oh . . . (spit) . . . what an adorable baby." And you're lucky if it's just affecting the scalp, as the term "cradle cap" implies. These patches can show up on the forehead, cheeks, nose, ears, buttocks, trunk, and more. But while it's gross, it's also benign and temporary. Severe cases may cause itching, but generally babies are oblivious to the condition. Doing nothing at all is an acceptable cradle cap treatment—it usually resolves itself within the first few months regardless of what you do.
But you will do something, and so would I. Cradle cap makes babies ugly and robs us of those first months of showing off Junior. Below I outline how to get rid of cradle cap using research-based treatments. But before you begin any cradle cap treatment, be sure to consult your child's physician.
Cradle Cap Treatment
Apply an emollient to loosen up the scales. Baby oil, mineral oil, petroleum jelly, or even vegetable oil will all work well. Slather it on over the affected areas. Keeping it on for fifteen minutes will suffice, but it can be left on overnight.
Next, rinse and use a soft-bristled toothbrush to gently rub away the scales. A fine-toothed comb or even a terry cloth rag will also work. Just don't overdo it—be gentle and know that it will take a couple of days to get rid of cradle cap and have your baby looking pageant-ready once again.
Shampoo more often and after emollient treatments. Babies only need their hair washed a few times a week, but making it a daily event will help get rid of cradle cap more quickly. Shampooing—using a regular old non-medicated baby shampoo—will loosen up the scales and flakes. After rinsing, use a soft-bristled toothbrush or terry cloth rag as described above, rinse again, and pat dry.
Use a low-potency hydrocortisone cream to get rid of stubborn, severe, or inflamed cradle cap. If the conservative treatments above fail to improve the situation, a 1% hydrocortisone cream can be used. Apply the cream to the scalp once daily or every other day, but for no longer than one week. If after a week you still haven't gotten rid of cradle cap, it's time to visit a doctor.
Ketoconazole 2% cream (Nizoral) is another medicated option. In limited studies, this anti-fungal cream has proven to be just as effective as hydrocortisone. It's also a more popular choice for cases that have spread to other areas on the body. Apply this cream to the baby's scalp once or twice a week for two weeks. For other areas on the body, apply daily for no more than two weeks.
When to Visit a Professional
If the above cradle cap treatments don't get results, it's time to again consult your child's physician. It's also a good idea to go in if your baby's cradle cap is spreading to the face or getting worse with treatment. More than likely, your doctor will recommend a dandruff shampoo containing salicylic acid, selenium sulfide (Selsun Blue), zinc pyrithione (Pert Plus), tar, or a stronger medication. Another possible scenario is that you're not actually dealing with cradle cap, but a similar infant skin condition such as atopic dermatitis, psoriasis, or tinea capitis.