The most common presenting sign is thick crusts or patchy scales on the scalp. Other signs are skin flakes, oily skin covered with flaky white scales, scales could also be yellow. There is also a possibility if mild redness. There could be similar lesions on the ears, eyelids, groin, armpits and nose. It generally does not irritate the baby or cause pruritus. It there are suspicions of prurits then another skin condition should be considered [5].

• Swelling

  Dermatitis causes Redness Swelling Oozing Crusting Scaling Blisters (sometimes) Thickening of skin (in chronic dermatitis) Itching is common. Open sores (ulcers) may develop. [merckmanuals.com]

  Dermatitis (eczema) is inflammation of the upper layers of the skin, causing itching, blisters, redness, swelling, and often oozing, scabbing, and scaling. [web.archive.org]

  They act as an anti-inflammatory which means that they can reduce any swelling or inflamed skin. Tea tree oil Tea tree oil is an essential oil which is used in a range of products that include soaps, lotions and shampoos. [medic8.com]

• Fever

  Call your child's provider if: Scales on your baby's scalp or other skin symptoms do not go away or get worse after home care Patches drain fluid or pus, form crusts, or become very red or painful Your baby develops a fever (may be due to infection getting [nlm.nih.gov]

  A sign of cradle cap becoming infected is fever and increased redness. Bleeding may also be seen if the scales are peeled off. Sometimes it spreads from the scalp to the other areas of the body. [newkidscenter.com]

  Doctors do not know what causes atopic dermatitis, but people who have it usually have many allergic disorders, particularly asthma, hay fever, and food allergies. [web.archive.org]

  Rarely, infants are affected by histologic-specific scaling, seborrheic dermatitis-like eruptions on the scalp with fever, and other systemic signs of acute Langerhans cell histiocytosis (Letterer-Siwe disease). [aafp.org]

• Overeating

  An over-the-counter antifungal shampoo will likely be recommended—but don’t use one unless your doctor advises you to do so. Originally published in 2010. [todaysparent.com]

  Over time, the crusts will soften and should lift off easily if you brush over them with a cotton bud or soft baby toothbrush. Don’t force the crusts, because this might make your baby’s skin bleed. [raisingchildren.net.au]

  However, scientists believe it may be due to over production of oil and a yeast called malessizia. [livestrong.com]

  Rub your fingers over the scaly patches, then gently peel and scrape away the scaly dead skin and discard it. [wikihow.com]

• Abdominal Pain

  Advanced Search: • Use “ “ for phrases o [ “pediatric abdominal pain” ] • Use – to remove results with certain terms o [ “abdominal pain” –pediatric ] • Use OR to account for alternate terms o [teenager OR adolescent ] [msdmanuals.com]

• Nausea

  Bulging of the soft spot in an infant's skull ( fontanelle ) Changes in alertness or consciousness Decreased appetite Dizziness Double vision (in young children) Drowsiness Hair changes, such as hair loss and oily hair Headache Irritability Liver damage Nausea [medlineplus.gov]

• Vomiting

  […] hair Headache Irritability Liver damage Nausea Poor weight gain (in infants and children) Skin changes, such as cracking at corners of the mouth, higher sensitivity to sunlight, oily skin, peeling, itching, and yellow color to the skin Vision changes Vomiting [medlineplus.gov]

• Jaundice

  Your newborn can develop a number of deficiencies and conditions—from eczema to jaundice—and you may not know what they are or how to deal with them. One of those “What’s this here?” conditions is cradle cap. [mustelausa.com]

• Eczema

  Factsheet: Infantile Seborrhoeic Eczema. National Eczema Society. [babycentre.co.uk]

  Periodically confused with infantile eczema, cradle cap is different from eczema in that it does not cause itching as eczema would. [earthclinic.com]

  Your baby may also have cradle cap if there's a family history of allergic conditions, such as eczema. [babycenter.com.au]

• Dry Skin

  Between the oil and the gentle exfoliation, you should be able to remove most of the dry skin. To finish, wash your baby’s hair with some warm water and normal shampoo. [smartmom.co]

  If your baby's scalp has flaky, dry skin that looks like dandruff, or thick, oily, yellowish or brown scaling or crusting patches, it's probably cradle cap. [babycenter.com]

  Read more: How to treat baby acne Relieve dry skin with an oatmeal bath Why your baby’s gut bacteria is so important No Comments [todaysparent.com]

  ® Eau de soin Advices Mustela and Me 1st Trimester 2nd Trimester 3rd Trimester Postpartum Normal baby skin Dry skin Very sensitive skin Atopic-prone skin Atopic-prone skin care Daily life with an atopic-prone skin Understand and prevent atopic-prone skin [mustela.com]

• Skin Disease

  Different species will start or aggravate different skin diseases. In the seborrheic dermatitis, M.restricta will play an important role, in the atopic dermatitis, M.globosa and/or M.restricta are major cutaneous microflora. [doi.org]

  Overview Seborrheic dermatitis: Despite its appearance, this skin disease is not caused by poor hygiene. Seborrheic dermatitis: Overview This is a very common skin disease that causes a rash. [web.archive.org]

• Pruritus

  SD treatment focuses on clearing signs of the disease; ameliorating associated symptoms, such as pruritus; and maintaining remission with long-term therapy. [doi.org]

  Steroids were also more effective in reducing erythema, scaling, and pruritus. Adverse effects were similar in both groups. [cochrane.org]

• Scalp Rash

  Frequently, a stubborn diaper rash accompanies the scalp rash. The specific causes are not known. Current theories for the cause of the disease include a weakened immune system, the lack of specific nutrients or issues with the nervous system. [en.wikipedia.org]

  Infantile seborrhoeic dermatitis Infantile seborrhoeic dermatitis causes cradle cap (diffuse, greasy scaling on scalp). The rash may spread to affect armpit and groin folds (a type of napkin dermatitis ). [dermnetnz.org]

  Frequently, a stubborn diaper rash accompanies the scalp rash. Older children and adults may develop a thick, tenacious, scaly rash with large flakes of skin. [web.archive.org]

• Irritability

  Irritation from a yeast that grows in the sebum (the substance produced by the glands) is also thought to be a possible culprit. But there's no consensus on the cause. Cradle cap isn't contagious. [babycenter.com]

  Cradle Cap Care gently eliminates cradle cap, calms scalp irritation and regulates the cutaneous flora. [uriage.com]

  This can irritate your baby’s skin and eyes, so you should dilute it in water if you do use it. Don’t be worried if the cradle cap comes back after treatment. This just means that your baby’s glands are still making extra oil. [raisingchildren.net.au]

Diagnosis of cradle cap is based solely on the history and physical findings. Laboratory, imaging or histological evaluation are of no added value.

There is no treatment for cradle cap as it is self-limiting and disappears on its own, whether it is caused by hormones or yeast. However, if the parents of the babies have cosmetic concerns, the following options may be considered. Gentle washing of the scalp is the commonest prescribed home remedy. The scales are then combed out gently and brushed off with a soft brush or cloth. This has to be done gently to avoid worsening the condition or causing baldness. Also, applying petroleum jelly and leaving it overnight is another popular home remedy. The scales readily fall off during the night and the remaining brushed off in the morning. Making a paste from sodium bicarbonate and applying in in the affected place for about 10 minutes can help to lift the scales. These are home remedies with no research data to back them up [6].
The use of shampoos remain controversial.

Mild baby shampoo is recommended by some sources for washing the infant hair. Dandruff shampoos that contain salicylic acid aren’t recommended as the active ingredient could be absorbed through the skin of the baby.

If the symptoms show no sign of abating after these home remedies, ketoconazole shampoos and creams may be useful. Ketoconazole has been shown to have a high level of efficacy in the treatment of moderate to severe forms of this condition and it is not absorbed through the skin. The corticosteroid hydrocortisone cream is useful in reducing redness and inflammation [7].

If the lesion is on the eyelid. The eye should be cleansed by a cotton swab soaked in well diluted baby shampoo.

This condition often clears as a baby grows older. It however, on rare occasions, persists into toddler years and even early childhood.

The cause of seborrheic dermatitis still remains largely unknown. Although it has been speculated that around the time of birth, some unidentified hormones are passed from mother to baby. These hormones then cause an abnormal stimulation of the oil producing glands (seborrheic glands) and hair follicles leading to increased production of oil (sebum) [2]. Another speculated cause is the yeast Malassezia. Malassezia is a fungus that grows in the sebum produced by the seborrheic glands.

It is generally a disease of infancy and it occurs between the ages of 3 weeks and 12 months. The peak prevalence age is 3 months as 70% of cases are seen in infants of that age. The prevalence decreases steadily afterwards. There has however been some reported cases in children over 1 year with as much as 7% of cases occurring in children between the ages of 1 and 2 years. It is common in all races and equally distributed between sexes [3].

In the same vein as the cause, the pathophysiology is not known. It is believed that there is transplancental migration of maternal androgens to the fetus. This androgens then stimulate the infant’s sebaceous glands. This stimulation even though seemingly insufficient to cause cradle cap, is necessary for its development.

A yeast fungus, Malassezia, has also been implicated although its role is unclear. Malassezia is a lipid dependent yeast whose colonization has been reported in infants with cradle cap. This fungus however has also been reported in other dermatological conditions and in normal infants.

Another implicated factor is biotin deficiency, possibly due to the effect of biotin on sebaceous glands. Biotin is a water soluble vitamin involved in the synthesis of fatty acids [4].

Daily shampooing of the baby’s hair with mild baby shampoo can help prevent the development of this condition [8].

Cradle cap is a harmless condition and it is usually self-limiting with most cases resolving within 12 months. Some children may have it for longer necessitating a medical visit. Although it is called cradle cap, similar lesions may appear on the baby’s armpits, eyebrows or eyelids [1].

• Definition: Cradle cap, also known as infantile seborrheic dermatitis, is a common condition in infancy in which there are white or yellow scaly lesions on the baby’s head. Similar lesions could also be seen on the eyelids, armpits and groin.
• Cause: There is no known specific cause although it has been attributed to some maternal hormones that are passed through the placenta to the fetus just before birth. These hormones act on the oil producing glands by overstimulating them. It could also be caused by a yeast fungus that grows in the secretion of these glands.
• Symptoms: The symptom of this condition is the scaly or crusty skin. This scales may be white or yellow in color and there could be redness due to inflammation. It doesn’t itch or cause any form of discomfort. If there are suspicions of itching, medical advice should be sought as it could be due to another skin condition [9].
• Diagnosis: The diagnosis is usually made from history and physical examination by the doctor. No laboratory tests are required.
• Treatment: It usually requires no treatment and tends to disappear as the child grows older. Some home tips could however help to manage the condition, like rubbing the baby’s scalp to loosen the scales, washing the hair with mild baby shampoo, and rubbing petroleum jelly to soften the scales. After the scales are gone, there should be periodic washing with shampoo to prevent a recurrence [10].

1. Wannanukul S, Chiabunkana J. Comparative study of 2% ketoconazole cream and 1% hydrocortisone cream in the treatment of infantile seborrheic dermatitis. J Med Assoc Thai 2004; 87 Suppl 2:S68.
2. Foley P, Zuo Y, Plunkett A, et al. The frequency of common skin conditions in preschool-aged children in Australia: seborrheic dermatitis and pityriasis capitis (cradle cap). Arch Dermatol 2003; 139:318.
3. Ruiz-Maldonado R, López-Matínez R, Pérez Chavarría EL, et al. Pityrosporum ovale in infantile seborrheic dermatitis. Pediatr Dermatol 1989; 6:16.
4. Bikowski J. Facial seborrheic dermatitis: a report on current status and therapeutic horizons. J Drugs Dermatol. Feb 2009;8(2):125-33.
5. High WA, Pandya AG. Pilot trial of 1% pimecrolimus cream in the treatment of seborrheic dermatitis in African American adults with associated hypopigmentation. J Am Acad Dermatol. Jun 2006;54(6):1083-8.
6. Tatlican S, Eren C, Eskioglu F. Insight into pimecrolimus experience in seborrheic dermatitis: close follow-up with exact mean cure and remission times and side-effect profile. J Dermatolog Treat. 2009;20(4):198-202.
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8. Seite S, Rougier A, Talarico S. Randomized study comparing the efficacy and tolerance of a lipohydroxy acid shampoo to a ciclopiroxolamine shampoo in the treatment of scalp seborrheic dermatitis. J Cosmet Dermatol. Dec 2009;8(4):249-53.
9. Tajima M, Sugita T, Nishikawa A, Tsuboi R. Molecular analysis of Malassezia microflora in seborrheic dermatitis patients: comparison with other diseases and healthy subjects. J Invest Dermatol. Feb 2008;128(2):345-51.
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