HOME

TheInfoList




Cradle cap causes crusty or oily scaly patches on a baby's scalp. The condition is not painful or itchy, but it can cause thick white or yellow scales that are not easy to remove. Cradle cap most commonly begins sometime in the first three months but can occur in later years. Similar symptoms in older children are more likely to be
dandruff Dandruff is a skin condition that mainly affects the scalp. Symptoms include flaking and sometimes mild itchiness. It can result in social or self-esteem problems. A more severe form of the condition, which includes inflammation of the skin, ...
than cradle cap. The rash is often prominent around the ear, the eyebrows or the eyelids. It may appear in other locations as well, where it is called infantile seborrhoeic dermatitis. Cradle cap is just a special - and more benign - case of this condition. The exact cause of cradle cap is not known. Cradle cap is not spread from person to person (contagious). It is also not caused by poor hygiene. It is not an allergy, and it is not dangerous. Cradle cap often lasts a few months. In some children, the condition can last until age 2 or 3.


Signs and symptoms

Cradle cap is seborrheic dermatitis that affects infants. It presents on the scalp as greasy patches of scaling, which appear thick, crusty, yellow, white or brown. The affected regions are not usually itchy and do not bother the child. Other affected areas can include the eyelids, ear, around the nose, and in the groin. Hair loss can also occur.


Causes

Cradle cap is not caused by bacterial infection, allergy or poor hygiene. Cradle cap is also not contagious. Doctors do not agree on what causes cradle cap, but the two most common hypotheses are fungal infection and overactive sebaceous glands. Cradle cap is an inflammatory condition. Possibly it has to do with overactive
sebaceous gland A sebaceous gland is a microscopic exocrine Exocrine glands are gland In animals, a gland is a group of cells in an animal's body that synthesizes substances (such as hormone A hormone (from the Greek participle , "setting in motion") is a ...
s in the skin of newborn babies, due to the mother's hormones still in the baby's circulation. The glands release a greasy substance that makes old skin cells attach to the scalp instead of falling off as they dry. There is a relationship with skin yeasts (''
Pityrosporum ovale ''Malassezia furfur'' (formerly known as ''Pityrosporum ovale'' in its hypha '' File:Hypha on rice.jpg, Hyphae growing on tomato sauce. '' Image:Conidium.png">Conidia on conidiophores A hypha (plural hyphae, from Greek ὑφή, ''huphḗ'', ...
'', newly renamed ''
Malassezia furfur ''Malassezia furfur'' (formerly known as ''Pityrosporum ovale'' in its hyphal form) is a species of yeast Yeasts are eukaryotic, single-celled microorganisms classified as members of the fungus kingdom. The first yeast originated hundred ...
'').


Warning signs

If the condition thickens, turns red and irritated, starts spreading, appears on other body parts, or if the baby develops thrush (fungal mouth infection), fungal ear infection (an ear infection that does not respond to antibiotics) or a persistent
diaper rash Irritant diaper dermatitis (IDD, also called a diaper rash) is a generic term applied to skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate Vertebrates () comprise all species of animal An ...
, medical intervention is recommended. Severe cases of cradle cap, especially with cracked or bleeding skin, can provide a place for bacteria to grow. If the cradle cap is caused by a fungal infection which has worsened significantly over days or weeks to allow bacterial growth (
impetigo Impetigo is a bacterial infection Pathogenic bacteria are bacteria Bacteria (; common noun bacteria, singular bacterium) are a type of Cell (biology), biological cell. They constitute a large domain (biology), domain of prokaryotic mi ...

impetigo
, most commonly), a combination treatment of antibiotics and antifungals may be necessary. Since it is difficult for a layperson to distinguish the difference between sebaceous gland cradle cap, fungal cradle cap, or either of these combined with a bacterial infection, medical advice should be sought if the condition appears to worsen. Cradle cap is occasionally linked to immune disorders. If the baby is not thriving and has other problems (e.g.
diarrhea Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery defecation, bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration of ...
), a doctor should be consulted.


Treatment

To help with cradle cap, parents can gently massage their baby's scalp with their fingers or a soft brush to loosen the scales. They may want to shampoo the baby's hair more frequently (no more than once a day), and after shampooing gently brush the baby's scalp with a soft brush or a terrycloth towel. Oil remedies can be used by rubbing a small amount of pure, plant-derived oil (coconut oil, pure olive oil, almond oil) on the baby's scalp and leaving it on for 15 minutes. After 15 minutes, gently comb out the flakes with a fine tooth comb or brush. Be sure to wash out all of the oil to avoid making the cradle cap worse. In cases that are related to fungal infection, such as
Tinea capitis Tinea capitis (also known as "herpes tonsurans", "ringworm of the hair", "ringworm of the scalp", "scalp ringworm", and "tinea tonsurans") is a cutaneous fungal A fungus (plural The plural (sometimes list of glossing abbreviations, abbrev ...

Tinea capitis
, doctors may recommend a treatment application of
clotrimazole Clotrimazole, sold under the brand name Lotrimin, among others, is an antifungal medication. It is used to treat vaginal yeast infections, oral thrush, diaper rash, pityriasis versicolor, and types of ringworm including athlete's foot and jock i ...

clotrimazole
(commonly prescribed for jock itch or athlete's foot) or
miconazole Miconazole, sold under the brand name Monistat among others, is an antifungal medication used to treat ring worm, pityriasis versicolor, and yeast infections of the skin or vagina. It is used for ring worm of the body, groin (jock itch), and ...

miconazole
(commonly prescribed for vaginal
candidiasis Candidiasis is a fungal infection Mycosis is an infectious disease An infection is the invasion of an organism's body Tissue (biology), tissues by Pathogen, disease-causing agents, their multiplication, and the reaction of host (biology), ...

candidiasis
). Doctors may recommend a treatment with a mild dandruff shampoo such as Selsun Blue even though the treatment may cause initial additional scalp irritation. A doctor may instead prescribe an antifungal soap such as
ketoconazole Ketoconazole, sold under the brand name Nizoral among others, is an antifungal drug, antifungal medication used to treat a number of fungal infections. Applied to the skin it is used for fungal skin infections such as tinea, cutaneous candidias ...

ketoconazole
(2%) shampoo, which can work in a single treatment and shows significantly less irritation than over-the-counter shampoos such as
selenium disulfide Selenium disulfide, also known as selenium sulfide, is a chemical compound and medication used to treat pityriasis versicolor Pityriasis commonly refers to flaking (or scaling) of the skin Skin is the layer of usually soft, flexible outer tis ...
shampoos. There are only a limited number of studies regarding the efficacy and safety of treatments for cradle cap and infantile seborrheic dermatitis. Several treatments including Promiseb, lactamide MEA gel, hydrocortisone 1% lotion, licochalcone 0.025%, flumethasone pivalate 0.02% ointment, and eosin 2% aqueous solution have been studied, however there is uncertainty regarding the efficacy and safety of these treatments. For adults: see the article on
seborrheic dermatitis Seborrhoeic dermatitis, also known as seborrhoea, is a long-term skin disorder. Symptoms include red, scaly, greasy, itchy, and inflamed skin. Areas of the skin rich in sebum, oil-producing glands are often affected including the scalp, face, and c ...
(the adult version of cradle cap).


Scalp, behind ears, eyebrows

If the cradle cap is not severe, it could simply be combed out gently after bathing. The softened scales can then be brushed away with a soft brush, comb or cloth, but if not done very gently, this could worsen the condition and bring about temporary hair loss. Applying
petroleum jelly Petroleum jelly, petrolatum, white petrolatum, soft paraffin, or multi-hydrocarbon, CAS number A CAS Registry Number, also referred to as CASRN or CAS Number, is a unique numerical identifier An identifier is a name that identifies (that is, ...
(e.g.,
Vaseline Vaseline Also pronounced with the main stress on the last syllable . is an American brand of petroleum jelly-based products owned by British-Dutch company Unilever. Products include plain petroleum jelly and a selection of skin creams, Soap, s ...
) liberally overnight is another popular treatment. The softened scales either fall off during the night, or can be brushed off in the morning. There is broad disagreement regarding the role of
shampoo Shampoo () is a hair care Hair care is an overall term for hygiene Hygiene is a series of practices performed to preserve health Health, according to the World Health Organization, is "a state of complete physical, Mental health, men ...

shampoo
s. Some sources warn against frequent shampooing, others recommend it. Mild baby shampoo is often recommended, but the exact denotation of the label "mild" in this context is not quite clear.
Baby shampoo Baby shampoo /ˈbā-bē/ /ʃæmˈpuː/ is a hair care product that is used for the removal of sebum, oils, dirt, human skin, skin particles, dandruff, environmental pollutants and other contaminant particles that gradually build up in hair; specia ...
s often contain detergent
surfactants Surfactants are compounds that lower the surface tension Surface tension is the tendency of liquid surfaces to shrink into the minimum surface area possible. Surface tension is what allows heavier than water i.e., denser than water object ...
, perfumes,
quaternium-15 Quaternium-15 (systematic name: hexamethylenetetramine chloroallyl chloride) is a quaternary ammonium salt used as a surfactant Surfactants are compounds that lower the surface tension (or interfacial tension) between two liquids, between a g ...

quaternium-15
and other eczemagenic irritants. No studies have been performed on non-prescription shampoos. In stubborn cases some doctors may recommend
keratolytic Keratolytic () therapy is a type of medical treatment to remove warts, calluses and other lesions in which the epidermis The epidermis is the outermost of the three layers that make up the skin, the inner layers being the dermis and Subcutaneo ...
(dandruff) shampoos (e.g. with
sulfur Sulfur (in nontechnical British English: sulphur) is a chemical element In chemistry Chemistry is the study of the properties and behavior of . It is a that covers the that make up matter to the composed of s, s and s: th ...

sulfur
,
selenium Selenium is a chemical element upright=1.0, 500px, The chemical elements ordered by link=Periodic table In chemistry Chemistry is the science, scientific study of the properties and behavior of matter. It is a natural science that ...

selenium
,
zinc pyrithione Zinc pyrithione (or pyrithione zinc) is a coordination complex of zinc Zinc is a chemical element with the Symbol (chemistry), symbol Zn and atomic number 30. Zinc is a slightly brittle metal at room temperature and has a silvery-greyish app ...
, or
salicylic acid Salicylic acid is an organic compound with the formula HOC6H4CO2H. A colorless, bitter-tasting solid, it is a precursor to and a active metabolite, metabolite of aspirin (acetylsalicylic acid). It is a plant hormone, and has been listed by the ...

salicylic acid
) while others warn against the use of medicated shampoos in newborns due to systemic absorption. Dandruff shampoos often contain
sodium dodecyl sulfate Sodium dodecyl sulfate (SDS) or sodium lauryl sulfate (SLS), sometimes written sodium laurilsulfate, is a synthetic organic compound , CH4; is among the simplest organic compounds. In chemistry, organic compounds are generally any chemical compou ...

sodium dodecyl sulfate
, a noted skin irritant.
Steroid A steroid is a biologically active organic compound In chemistry Chemistry is the study of the properties and behavior of . It is a that covers the that make up matter to the composed of s, s and s: their composition, structure, ...
and
tar Tar is a dark brown or black viscous The viscosity of a fluid In physics Physics is the that studies , its , its and behavior through , and the related entities of and . "Physical science is that department of knowledge ...

tar
preparations have also been used but may have drawbacks. The immunomodulators
tacrolimus Tacrolimus, sold under the brand name Prograf among others, is an immunosuppressive drug Immunosuppressive drugs, also known as immunosuppressive agents, immunosuppressants and antirejection medications are drugs that inhibit or prevent acti ...
/Protopic and
pimecrolimus Pimecrolimus is an immunomodulating agent of the calcineurin inhibitor Immunosuppressive drugs, also known as immunosuppressive agents, immunosuppressants and antirejection medications are drugs that inhibit or prevent activity of the immune s ...

pimecrolimus
/Elidel have not been approved for children under two years.
Ketoconazole Ketoconazole, sold under the brand name Nizoral among others, is an antifungal drug, antifungal medication used to treat a number of fungal infections. Applied to the skin it is used for fungal skin infections such as tinea, cutaneous candidias ...

Ketoconazole
shampoos and creams are currently shown to be the most effective medical treatment of moderate to serious cradle cap. There appears to be little to no absorption of topical ketoconazole into the bloodstream.


Eyelids

Typical medical advice is to use baby shampoo, diluted with warm water, on a cotton swab to cleanse the eyelid. There is no agreement on the dilution, which ranges from as high as a 1:1 mix to as low as a few drops of shampoo per half-cup of water.


Prognosis/differential diagnosis

Assurances that this condition will clear as the baby matures are very common. However, the condition occasionally persists into the toddler years, and less commonly into later childhood. It tends to recur in adolescence and persists into adulthood. In an Australian study, about 15 percent of previously diagnosed children still had
eczema Dermatitis is inflammation of the Human skin, skin, typically characterized by itchiness, erythema, redness and a rash. In cases of short duration, there may be small blisters, while in long-term cases the skin may become lichenification, thick ...

eczema
10 years later. It is common that people mistake cradle cap for
atopic dermatitis Atopic dermatitis (AD), also known as atopic eczema, is a long-term type of inflammation of the skin (dermatitis). It results in puritis, itchy, red, swollen, and cracked skin. Clear fluid may come from the affected areas, which often thickens ov ...

atopic dermatitis
due to the common symptomatology. Unlike some signs and symptoms of cradle cap, atopic dermatitis affect infants' sleep and feeding habits with moderate to severe itching. In addition, one of the physical diagnosis of atopic dermatitis is poor crusted lesions on certain surfaces of the baby, such as scalp and cheek. Rarely, it turns out to be misdiagnosed
psoriasis Psoriasis is a long-lasting, noncontagious autoimmune disease An autoimmune disease is a condition arising from an abnormal immune response to a functioning body part. There are at least 80 types of autoimmune diseases. Nearly any body part c ...

psoriasis
.


References


External links

* {{DEFAULTSORT:Cradle Cap Babycare Infancy
Seborrheic dermatitis Seborrheic dermatitis is a chronic, superficial, inflammatory disease characterized by scaling on an Erythema, erythematous base. Dermatitis ...