By: Sarah Stein, MD, FAAD, FAAP
Your beautiful one-month-old baby has thick, yellowish scales on their scalp. You may also notice scales or redness on their face, in their neck folds and behind their ears. What is it? What should you do?
This oily rash on your baby's scalp is called
cradle cap. It's a type of seborrheic dermatitis that's found on the head.
Cradle cap usually starts between three weeks and two months after birth. It's extremely common in babies. In fact, 70% of three-month-olds have cradle cap.
What does cradle cap look like?
Here are examples of what cradle cap looks like on lighter and darker skin.
Photo credit: Pediatrics in Review (American Academy of Pediatrics)
Can cradle cap spread?
This scaly rash may show up in other places too, such as your baby's face, armpits, neck crease and diaper area. When it's not on the scalp, it is called seborrheic dermatitis.
Cradle cap and seborrheic dermatitis are rarely itchy or uncomfortable. They aren't contagious either.
What causes cradle cap?
No one knows exactly what causes cradle cap. One theory is that it's a reaction to some common yeast that everyone has on their skin. Another theory is that the mother's hormones cause the baby's oil glands to overproduce.
Cradle cap isn't caused by an allergic reaction or an infection. It doesn't happen from poor hygiene either.
Cradle cap treatment
You don't need to treat cradle cap. But you can take steps to help the scales come off more easily, including:
Wash your baby's hair more often. Every other day is helpful for most babies. If your baby has another skin condition, ask your pediatrician or dermatologist how often you should bathe them.
Use a mild baby shampoo. Check with your pediatrician before using a medicated shampoo. This may irritate your baby's skin.
Loosen scales while shampooing. You can do this with gentle massage, a soft brush or a baby comb. For tough scales, apply a little mineral oil, coconut oil or petroleum jelly. Let it sit overnight to soften the scales. Wash and massage or brush your baby's scalp as usual.
Keep in mind:
It may be tempting, but don't scratch or pick at the scales. This increases the risk of infection.
Don't be alarmed if your baby's hair comes off
with the scales. It will grow back.
How to prevent cradle cap from coming back
Once the scales are gone, keep washing your baby's hair frequently with a mild baby shampoo. This will help stop the cradle cap from coming back.
How long does cradle cap last?
Cradle cap usually goes away by itself within weeks or months. In most cases, it has cleared up by 1 year old, but some toddlers continue to have some flaky build up on their scalps.
When to see your pediatrician
See your pediatrician if the cradle cap becomes crusted, weepy or has pus bumps. They may recommend using an antifungal cream or hydrocortisone cream to help. They can also check for any signs of other conditions or infections.
If you notice any of the following signs or symptoms, talk with your pediatrician:
A rash in other places besides the scalp, especially if it's severe
The rash has an odor
Your baby appears to be in pain or discomfort
There is oozing fluid or bleeding from the scales
The affected skin looks swollen
About Dr. Stein
Sarah Stein, MD, FAAD, FAAP, a member of the American Academy of Pediatrics Section on Dermatology, is Associate Professor and Director of Pediatric Dermatology for UChicago Medicine.