Cradle-Cap: Myths demystified

Cradle cap is a patchy, greasy, scaly and crusty skin rash that occurs on the scalp of infants and sometimes toddlers. It is a variant of seborrhoeic dermatitis that is confined to the scalp but can very rarely involve other areas of the body such as behind the ears, in the creases of the neck, armpits and diaper area.

In my years of practice in Pediatric Dermatology, I have come across many myths and queries about common skin condition called as ‘Cradle cap’.

Q- Is it because of poor hygiene or some wrong foods eaten by the mother?
Ans This is the most common myth associated with cradle cap.It is not due to poor hygiene , food or any infection. It is rather one of the commonest skin conditions in pediatric age group.

Q- Doe this harm my baby?
Ans- This is absolutely harmless and is mostly non itchy.

Q- Does it require treatment?
Ans “ Cradle cap ‘ generally requires no treatment apart from regular application of oil and gentle combing of the skin flakes without rubbing. You need to consult Your Pediatric Dermatologist if the baby has itchy scalp or the skin looks inflamed.


A birthmark is kiss from angel but certainly it is a common distress for the parents. We would discuss the common concerns around them which bother most of my patients.

Salmon patches
These are the commonest type of birthmark in newborn babies. They are usually present at the time of birth and are flat, dull-red areas that can be present on the eyelids, bridge of the nose, the upper lip and on the nape of the neck.

Port wine stain

A port wine stain is a pink or red coloured patch on the skin that is usually present at birth.

Q- Are they hereditary?

Ans - Usually they are not hereditary.

Q- How does a Port wine stain look like and where it is mostly situated?

Ans- Port wine stains usually occur on the face and neck and less often on the trunk and limbs.They can become deeper red or purple in colour and may become nodular in later age. Rarely bleeding can happen if ulcerated.-

Q- Can port wine stains be cured?

Ans - They can be made much less obvious by the treatments listed below.
1.Laser treatment. Pulsed dye laser (PDL) is the treatment of choice It is helpful in improving the appearance of PWS on the face .Port wine stains on the limbs respond less well than those on the face. Treatments given before the birthmark becomes thickened are more successful.

2.Cosmetic camouflage. Cosmetic or camouflage creams are often very helpful.

3.Strawberry NAEVI

Q- What are strawberry naevi?

Ans- These are bright red, soft raised swellings on the skin which give an appearance of a strawberry. They are also known as ‘infantile haemangiomas’. They usually appear after birth, often within the first month, and may occur anywhere on the skin.

Q- Did I do something wrong during my pregnancy that 'Strawberry NAEVI' developed?

Ans - This is one of the most common myths associated with strawberry haemangiomas. Strawberry naevi are not a sign of ill health, or associated with cancer. There are many myths about their cause that should be discounted and parents should not feel responsible if their child develops one. They have absolutely no correlation with any maternal habits during pregnancy.

Q- What is the natural evolution of haemangiomas?

Ans - At birth, strawberry naevi are usually absent or appear as a red or bruise-like patch. After birth there is a rapid growth phase usually in the first 5 to 8 weeks.  Most strawberry naevi (80%) reach their final size by 3 months.  The early growth phase is followed by a slower growth phase. Finally the strawberry naevus regresses or becomes smaller in size and resolves (involutes) over a period of years (usually 3 years). Most haemangiomas cease to improve after 3.5 years of age.
Usually there is only one strawberry naevus, but sometimes several may occur.  They can appear on any area of skin but a majority (60%) appear on the face and neck. If the haemangioma is near the surface of the skin, it will be bright red, like a strawberry, whereas it is blue in colour when located deeper. When located deep beneath the skin, the haemangioma may appear to be skin coloured.

Q- Is there any treatment for strawberry hemangioma ?

Ans - Most of them do not require treatment as they resolve spontaneously. Active non-intervention is the best option and consists of education of the parents and reassurance that the naevus will resolve spontaneously.

What are the Current treatment options for strawberry hemangioma ?

1.Beta blockers
.Propranolol Oral propranolol is now considered by most experts to be the first-line treatment for strawberry naevi requiring treatment and has been successfully used in babies with large complicated haemangiomas. It is effective in halting the growth and diminishing the size of strawberry naevi. 
.Timolol solution is also being used to treat smaller strawberry naevi..

2Steroids have been used for rare haemangiomas that are life threatening or dangerous because of their size or location.

3.Laser treatment (pulsed dye laser therapy) available in specialist dermatology centres can be used to stop bleeding in ulcerated haemangiomas, and can speed up healing and shrinkage of the haemangioma.

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