ConditionChildren's health
Cradle Cap
Cradle cap is a common, harmless skin condition in babies that causes patches of greasy, yellow or white scales on the scalp. It is the infant form of seborrheic dermatitis. It usually appears in the first 2 to 3 months, does not itch or bother the baby, and clears by itself within weeks to months, usually by the first birthday. Gentle washing, softening the scales with oil and brushing them away is usually all that is needed.
Also called: Infantile seborrheic dermatitis, crusta lactea, milk crust, seborrheic dermatitis of infancy
At a glance
- What it is
- Greasy, yellow or white scaling on a baby's scalp, the infant form of seborrheic dermatitis.
- Who gets it
- Very common in babies from about 2 weeks to 12 months.
- Symptoms
- Scales and crusts, sometimes mild redness; usually not itchy.
- Can spread to
- Eyebrows, eyelids, behind the ears, skin folds and the diaper area.
- Treatment
- Gentle washing, oil to loosen scales, soft brushing; medicated cream if needed.
When to get help
See a doctor within a day or two
- A baby under 3 months with a fever of 38 °C (100.4 °F) or higher
- Red, swollen, hot or weeping skin, yellow crusts or pus, or the baby seems unwell (possible infection)
Book a routine appointment
- Cradle cap that spreads to the face and body, or is very red
- Itching, with the baby rubbing their head or skin (possible eczema)
- Cradle cap that does not improve after a few weeks of home treatment, or persists after 12 months
- Thick scales with patchy hair loss
Usually safe to manage at home
- Yellow, greasy scales on the scalp of a baby who is otherwise well and not itchy
What cradle cap looks like
- patches of yellow, brown or white scales, greasy or dry
- thick crusts on the top of the head, sometimes covering much of the scalp
- flaking that looks like dandruff
- mild redness under the scales
- sometimes scales on the eyebrows, eyelids, nose creases, behind the ears, neck folds and the diaper area
Babies usually do not seem bothered. Hair may come away with the scales, but it regrows.
What causes cradle cap
The exact cause is not fully understood. Contributing factors include:
- Overactive oil glands stimulated by the mother's hormones before birth
- Malassezia yeast, which normally lives on skin and may trigger inflammation in oily areas
Cradle cap is not caused by poor hygiene, it is not an allergy, and it is not contagious.
Cradle cap vs other rashes
| Condition | Clues |
|---|---|
| Cradle cap (seborrheic dermatitis) | Greasy yellow scales, mainly scalp and skin folds, not itchy, starts in first 3 months |
| Atopic dermatitis (eczema) | Dry, red, very itchy patches, often on cheeks and outer arms and legs, usually starts after 2 to 3 months |
| Diaper rash | Red rash in the diaper area, sometimes caused by seborrheic dermatitis spreading |
| Scalp ringworm | Scaly patches with hair loss, rare in young babies |
| Psoriasis | Well-defined red plaques with silvery scales, rare in infants |
Some babies with cradle cap later develop eczema, and the two can be hard to distinguish at first.
How to treat cradle cap at home
- Soften the scales: massage a small amount of mineral oil, petroleum jelly or a plain baby oil into the scalp. Leave it on for 15 minutes or up to a few hours.
- Loosen gently: use a soft baby brush, a soft toothbrush or a fine-toothed comb to lift the scales.
- Wash: shampoo with a mild baby shampoo to remove the oil and loosened scales. Rinse well.
- Repeat: wash the scalp daily or every other day while scales are present, then 2 to 3 times a week to prevent build-up.
Tips
- Do not pick or scratch the scales, which can cause bleeding and infection.
- Avoid olive oil, which may encourage yeast growth in some babies.
- Do not use adult dandruff shampoos unless a doctor advises, since some ingredients are not suitable for babies.
- Leaving oil on too long without washing can make cradle cap worse.
Medical treatment
If home treatment does not work:
- Antifungal cream or shampoo, such as ketoconazole, used as directed by your pediatrician.
- Mild hydrocortisone cream for short periods if the skin is red and inflamed.
- Treatment for secondary infection if the skin becomes red, swollen or weeping.
Outlook
Cradle cap usually improves within weeks and almost always clears by 12 months. Occasionally it lasts into the toddler years. It does not cause permanent hair loss or scarring. Some children develop seborrheic dermatitis or dandruff later in life.
Frequently asked questions
What causes cradle cap?
Cradle cap is thought to be caused by overactive oil glands in the baby's skin, stimulated by hormones from the mother before birth, and a normal skin yeast called Malassezia. It is not caused by poor hygiene or allergies.
How do I get rid of cradle cap?
Massage a little mineral oil or petroleum jelly into the scalp to soften the scales, wait 15 minutes or more, brush gently with a soft brush, then wash with mild baby shampoo. Repeat daily until the scales clear.
Is cradle cap itchy or painful?
Usually not. Most babies are not bothered by cradle cap. If your baby seems itchy or rubs their head, it may be eczema, and you should talk to your pediatrician.
When does cradle cap go away?
Most cases clear on their own within a few weeks to months and are gone by the first birthday. Occasionally it persists into toddlerhood. Regular gentle washing helps it clear faster.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Dermatology: Cradle cap: how to treat
- American Academy of Pediatrics (HealthyChildren.org): Cradle cap
- NHS: Cradle cap
- MedlinePlus: Cradle cap
- DermNet: Seborrhoeic dermatitis in infants