Cradle cap is a term used to refer to any red scaly rash on the scalp of babies. Cradle cap is not a medical diagnosis, but simply a descriptive term, like the term diaper dermatitis.
There are a few causes of Cradle cap, including Seborrheic dermatitis, Atopic Dermatitis and Plaque Psoriasis. Seborrheic dermatitis is the most common cause of cradle cap. Before Cradle Cap can be treated, the specific cause of the Cradle cap must first be diagnosed. To diagnose the cause of the Cradle cap your doctor will have to examine the baby from head to toe.
A concomitant rash in the skin-folds and the nappy area might indicate Seborrheic dermatitis, whereas a generally dry skin might indicate Atopic Dermatitis as the cause of the Cradle cap. Nobody knows exactly why babies develop Seborrheic dermatitis or Atopic Dermatitis. The theory is that Seborrheic dermatitis is related to the overgrowth of the yeast Pityrosporum ovale which was recently renamed Malassezia furfur. The yeast overgrows because of overactive oil glands on the scalp. The oil glands become overactive because of genetic influences or perhaps because of hormones passed to the baby from the mother. Seborrheic dermatitis is not due to bad hygiene or a bad diet! Perhaps as many as 50% of babies born in the developed world have some degree of cradle cap.
Once the diagnosis is made, treatment can be started. The following treatment options will apply especially to Cradle cap caused by Seborrheic dermatitis.
The are really 2 aspects of Cradle cap to treat; scaling and redness. The scaling develops from the areas of redness. Once the redness is resolved the scaling will cease. Initially however, treatment is targeted at both scaling and redness.
Redness can be treated with mild topical corticosteroids. Corticosteroids is not dangerous if used correctly and sparingly. Do not let anybody tell you different, because mild topical corticosteroids can rapidly improve the condition and make your baby feel better. Mild topical corticosteroids should be applied once of twice per day while there is redness. If there is no redness do not apply any corticosteroids.
Ketoconazole containing shampoos can also help. Ketoconazole is an anti-fungal that will help to eradicate yeasts. It is a good idea to dilute the Ketoconazole shampoo perhaps 50:50 or greater initially, to make sure the shampoo does not irritate the babies skin. Use the shampoo every second day initially. Ketoconazole creams can also be applied once or twice per day to the red areas.
Scaling is treated by moisturising the skin. Many different oil and creams can be used for this. Examples include Vaseline, over-the-counter moisturizers, olive oil, borage oil, tea-tree oil, aloe gel etc.
Cradle cap due to Seborrheic dermatitis will resolve spontaneously within a few months in the vast majority of babies.
