The first few months of a newborn’s life are full of intensive learning experiences for parents. They involve hours of tending to the newborn, creating a bond, learning about their needs, and being on constant surveillance for anything that may not be right with their health and development. As parents, any sign of abnormality can be a cause for alarm, and understandably so—babies cannot express their discomfort quite yet, so it’s up to the parent to interpret the signs.One condition that affects up to 10% of all infants between one day and three months old is infantile seborrheic dermatitis—more well known as cradle cap. It is a common condition in newborns and has a set of distinctive defining characteristics
. But fear not, parent, cradle cap has been studied extensively by pediatric health professionals and they have concluded that it is neither a permanent condition nor a sign of health defects. It may look scary, but it is harmless. In this article, we draw from the latest research on the condition to guide you to understand what it is, what causes it, some treatment methods, statistics on infants with cradle cap, and clinical presentations of cradle cap and dandruff. With this information, you’ll be more knowledgeable about their condition and how to take care of it.
What is Cradle Cap?
Cradle cap is a chronic non-inflammatory condition. It manifests itself as greasy, yellowish scaling of skin in various parts of an infant’s body. The appearance may cause a scare for parents and can sometimes be confused with dandruff. However, there is a distinctive difference between the two despite their being on the same continuum of conditions occurring in seborrheic
areas of the body. Dandruff develops only on the scalp and with it comes itchiness and flaking of skin
but without visible inflammation. On the other hand, cradle cap is more spread out in the body, appearing most prominently in areas with high sebaceous gland activity—including the scalp, ears, and the t-zone of the face. Like dandruff, SD may sometimes, although rarely, cause itchiness but differs in appearance from dandruff—often having non-inflammatory greasy plaques covered with yellowish scaling skin.
For you, the parent, it may be a relief to know that cradle cap does not cause your infant discomfort. Although it may look painful and uncomfortable, SD is generally neither pruritic (an unpleasant sensation that urges to scratch) nor is it inflammatory. The asymptomatic nature of the condition allows the infant to enjoy their activities without side effects or hindrance from cradle cap.
Causes of Cradle Cap?
Although cradle cap is a prevalent condition amongst infants, research has not found conclusive evidence of conditions that cause it. However, there are various factors that are theorized to lead to the development of cradle cap. So far, pediatric research has found consistent connections between sebaceous secretions and fungal colonization on the skin and the development of cradle cap.
Other research has found connections between the mother’s hormone levels
and an infant’s sebaceous gland activity
—the gland that controls sebum production in the body. It is hypothesized that during pregnancy, the mother’s hormones influence the baby’s levels of sebaceous gland activity and the imparted effects continue into the infant’s first few months of life.It’s important to note here that there has been a consistent relationship between sebum production in the infant’s body and development of cradle cap. Children who produce high levels of sebum have been found to make up the majority of patients with cradle cap. Furthermore, production of Malassezia, a yeast, has been linked to over 80% of cradle cap cases.
It’s important to note here that research thus far has linked cradle cap to internal physiologies and hormonal levels of the infant. It is not, however, linked to the child’s hygiene—hence, not an indicator of poor hygiene care in part of the parents. It is also not contagious—so your baby can enjoy play time with other kids.
Treatment or Cradle Cap
Cradle cap cannot be prevented, but it can be treated with careful care of the affected areas. Pediatric doctors recommend conservative use of products in caring for cradle cap and that letting the condition cure with time is the best approach with the help of proven products that help in reducing the appearance of the condition.
Here is a step by step recommended wash routine to treat cradle cap on the head:
- Soak the baby’s hair with water
- Use a mild shampoo to cleanse the hair
- Gently spread an emollient on the hair. Here, you can use mineral oil, baby oil, or white petrolatum. If you can leave this on for a prolonged period of time, the better the results will be. This is because the emollient directly interacts with the dry skin and breaks up the scaly skin.
- Using a soft brush, gently brush your baby’s head focusing on scaly areas. This is the scale removal process
- Gently shampoo to remove the oils
- Pat dry and apply recommended topical creams such as Hydrocortisone 1%, Ketoconazole 2%
For other areas of the body, follow the same procedure using a gentle body wash, oil, and soft brush. A key thing to remember is that cradle cap is a self-limiting condition
in nature, meaning it does not continue after a certain period of time. Also keep in mind that due to the various factors likely to be associated with developing cradle cap, results from recommended treatments may vary. Therefore, if you worry that the condition is worsening, it is wise to visit your pediatrician
for further guidance.
Statistics about Cradle Cap
Cradle cap appears most often in infants between 0 and 3 months
. Cases of cradle cap have been highly reported in 3-month-old infants than any other age in that demographic. Seborrheic dermatitis
, the larger term for cradle cap, is a common dermatological condition worldwide that peaks at different ages; 3 months, puberty, and between 40 and 60 years.
Cradle cap affects more male (3%) infants than female infants (2.6), a fact that has led researchers to suggest it is linked to sex hormones such as androgens. However, there are no observed differences in the prevalence of the condition along ethnic lines.
Researchers have found that a disproportionately high percentage of those affected by SD and cradle cap have compromised immune systems from cases such as lymphoma, HIV/AIDS, and organ transplant recipients
In children, it has been reported that 10% of those younger than one month are affected while 70% of cases occurred in 3-month-old infants and the percentage drops with increasing age, leaving only 7% with the condition beyond the first year of life. Although some cases are more lasting than others, the general trend is that the condition completely cures within the first year of a child’s life.
Clinical presentations of seborrheic dermatitis (SD) and dandruff
Because it may appear in various parts of the body, infantile seborrheic dermatitis varies in how it looks from one baby to another. However, there are generally some agreed upon telltale signs that indicate the development of cradle cap. Let’s look at the signs as they appear in different parts of the infant’s body.
- Skin folds: areas affected around the neck and areas behind the knees have the appearance of shiny, non-scaly lesions.
- Middle body: around the middle part of the body (the chest and abdomen, there appears some scaling. It often appears on the abdomen.
- Scalp: this is the most common area where cradle cap appears. Affected areas appear scaly and greasy and can be yellow in color
- Facial area: affected areas have a salmon-colored flaky look. Areas around the eyebrows and eyelids as well as the nose are especially prone to cradle cap due to their high sebum concentration.
Dandruff is characteristically different from seborrheic dermatitis, but it is often confused with SD. We can discern some key differences by looking at the clinical presentations of dandruff. Here are some clues that can help you better judge your child’s condition.
: dandruff is characterized by fine dry flaking of skin. The flakes tend to be white or yellow and they are associated with itchiness in the affected areas. In infants, dandruff most prominently appears on the scalp and occasionally on the eyebrows, or on the back.·Tinea capitis
: this is another dermatological condition that is seen predominantly in children. It is a fungal infection at the cutaneous level. It is characterized by patches of hair loss and it is highly contagious.·Systemic Lupus Erythematous
: this condition appears on the facial regions and it looks like a common rash. The rash appears to avoid developing around the nose bridge and nasal folds and the infant may be extremely photosensitive as a side effect.
: this condition also appears on the face—specifically the nose and folds around the mouth and nose. It causes some skin peeling and mild lesions.
: psoriasis is characterized by the color of scales (greyish white) and the thickness of the plaque. It is common in children and is associated with the presence of psoriasis in the family.
: this condition tends to occur in the scalp and cheek area. It causes itchiness and turns the affected skin to a reddish color. In children, it often occurs after the first three months and it is influenced by family history on conditions such as asthma and eczema.
Now that you know more about what infantile seborrheic dermatitis—what it is and what it isn’t, you can probably be more confident in taking care of your child. However, ruling that it is SD does not take out the obligation to see a pediatrician for further help and medication to help the condition. With this information, you’re in a better position to support your child’s dermatological health!