Cradle Cap in Babies: Causes and Gentle Care

If you notice yellow, greasy flakes or thick crusty patches on your baby's scalp, you are probably looking at cradle cap. It can look a little alarming, and it is not the cute baby hair you were hoping to show off, but it is very common and almost always harmless. This guide explains what causes it, how to care for it gently at home, what to avoid, and when it is worth a call.

What cradle cap is

Cradle cap is the common name for a skin condition called seborrheic dermatitis when it shows up on a baby's head. It usually appears between about 3 weeks and 3 months of age. You may see:

• Yellowish or white scales on the scalp, which may look oily or dry.
• Thick, crusty patches, sometimes covering a large part of the head.
• Flaking that looks a bit like dandruff.
• Mild redness under or around the scales.

The same type of rash can appear on the eyebrows, eyelids, behind the ears, on the sides of the nose, in neck folds, armpits or the diaper area.

What causes it

Doctors do not know the exact cause. It is likely related to extra oil made by a baby's skin glands in the early months, possibly influenced by hormones passed from parent to baby before birth. A common yeast that normally lives on the skin may also play a role.

A few things are clear:

• It is not caused by poor hygiene or anything you did wrong.
• It is not an allergy.
• It is not contagious.
• It usually does not itch or bother the baby.

Gentle care at home

Cradle cap often goes away on its own over weeks to months, and most cases are gone by the first birthday. Treatment is not required. Still, many parents want to loosen the scales so the scalp looks and feels better. The American Academy of Pediatrics describes these steps in its article on what cradle cap is and how to care for it.

1. Wash more often. Shampoo your baby's hair every day or every other day with a mild baby shampoo while scales are present.
2. Massage while washing. Use your fingertips or a soft washcloth to rub the scalp gently in small circles. It is safe to wash over the soft spot.
3. Brush gently. After rinsing, use a soft baby brush or a fine-toothed comb to lift loosened flakes. Brush in one direction, lightly.
4. Soften stubborn scales. For thick crusts, rub a small amount of mineral oil or petroleum jelly into the scalp and leave it for a while, even overnight. Then wash it out well with shampoo. Oil left on the scalp can make cradle cap worse, so rinse thoroughly.
5. Keep it up. Once the scalp is clear, regular washing with mild shampoo can help keep scales from coming back.

Some hair may come off with the scales. That is normal, and it grows back.

What not to do

• Do not pick or scratch off the scales. Pulling them off can break the skin and let infection in.
• Do not scrub hard. A light touch works better and protects the skin.
• Do not use adult dandruff shampoos, medicated shampoos or steroid creams unless your pediatrician recommends them. Some contain ingredients that are not meant for babies.
• Be careful with home remedies. Some oils that are popular online can irritate a baby's skin or feed the yeast linked to cradle cap. Ask your pediatrician before trying something new, and avoid nut-based oils if anyone in the family has nut allergies.
• Do not use essential oils on a baby's skin.

Cradle cap or something else?

Other skin problems can look similar. Eczema, for example, tends to be itchy and dry rather than greasy, and often shows up on the cheeks, arms and legs. Ringworm of the scalp, a fungal infection, can cause round scaly patches with hair loss, but it is rare in young babies. If you are not sure what you are seeing, your pediatrician can usually tell just by looking.

When a rash also shows up in the diaper area or skin folds, it is often the same seborrheic dermatitis. These areas sometimes need a different approach, so let your pediatrician take a look.

What to expect

Cradle cap usually improves with gentle washing within a few weeks, though it can come and go for several months. It does not leave scars, and it does not mean your baby will have skin problems later. If it is not getting better with home care, your pediatrician may suggest a stronger shampoo or a cream made for babies.

When to call us

Call your A thru Z Pediatrics office if:

• The patches become red, swollen, warm, weepy, crusted with yellow fluid, bleeding, or have pus bumps or a bad smell. These can be signs of infection.
• The rash spreads to the face, body or diaper area, or seems itchy or painful.
• Cradle cap is not improving after a few weeks of gentle home care.
• Your baby is not feeding well, seems unwell, or is not gaining weight.
• Your baby is under 3 months old and has a temperature of 100.4°F or higher. Call right away.

Call 911 if your baby has trouble breathing, is limp or very hard to wake. To have your baby's scalp checked, request a visit. You can read more about baby skin conditions on MedlinePlus.