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What is Cradle Cap?
Cradle cap, the common term for seborrheic dermatitis of the scalp, is a greasy, yellowish, crusty, scaly rash that appears in patches on the scalps of young infants. It is quite common and generally appears within the first 3 months of life. It is usually safe and non-contagious, and rarely causes the infant any discomfort. Cradle cap is also known as crusta lacteal, honeycomb disease, milk crust, pityriasis capitis, and infantile seborrheic dermatitis.
Cradle cap is believed to affect 10% infants up to the age of 1 month, and the prevalence peaks at 70% by 3 months of age. It usually clears up on its own in couple of weeks. However, if it persists or seems severe or spreads, you may consult your doctor. In a more severe case of cradle cap, bacteria can develop in areas that might be cracked or bleeding. It is important to inform the doctor of other problems such as diarrhea, as these could be linked to cradle cap.
What triggers it?
The underlying cause of cradle cap is not known. Overactive sebaceous glands might produce too much sebum, which can prevent the old skin cells from drying and falling off the scalp. Instead, they stick to the scalp. The reason why the glands are overactive may be because maternal hormones stay in the baby’s body for some months after birth. Fungal infection (by the Malassezia genus) could be due to the consumption of antibiotics by the mother before delivery or because the baby was fed antibiotics up to a week after birth. Antibiotics can also destroy the useful bacteria that prevent fungal infections.
Cradle cap is not caused by poor hygiene, allergy, bacterial infection, or bad hygiene.
What are the symptoms of cradle cap?
Common signs of cradle cap include patchy scaling or thick crusts on the scalp, oily or dry skin covered with flaky white or yellow scales, skin flakes, and possibly mild redness.
How is it treated?
Cradle cap usually does not require medical treatment, as it usually goes away on its own. Washing the baby’s hair once a day with mild baby shampoo helps. If the scaling is heavy, application of mineral oil to the scalp for a couple of hours before shampooing might be useful. The scalp should be brushed lightly with a soft brush to loosen the scale.
The doctor might prescribe low-potency hydrocortisone cream or a shampoo with 2% antifungal ketoconazole medication. Do not use over-the-counter cortisone or antifungal creams, because some of these products can be toxic when absorbed through a baby’s skin. Salicylic acid-containing dandruff shampoos are not recommended for use in babies either, because they can be absorbed through the skin. Any oil or lotion should be applied before shampoo as leaving the oil on can cause more scales to form. Do not scratch the scalp.
Shampooing the baby’s hair every few days can help prevent cradle cap. Stick with a mild baby shampoo unless the doctor recommends something stronger. However, if cradle cap has been treated and the patches have gone, gentle washing and brushing will prevent recurrence. Sometimes in severe cases the rashes may spread to areas like behind the ears, chest , back and diaper area. Atopic Dermatitis does not involve the diaper area unlike seborrheic dermatitis. Some patients with seborrheic dermatitis may later on develop atopic eczema as well though this is not a rule.
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