Childhood seborrheic dermatitis or cradle cap

Rash on the scalp:

Your beautiful one month old baby has grown scales and has a red scalp. She's worried and she thinks that maybe she shouldn't shampoo like she usually does. She also notices redness in the folds of her neck and underarms and behind her ears. What is she to do?

When this rash occurs only on the scalp, it is known as cradle cap or cradle cap. But while it probably started as scaly and red areas of the scalp, it can also be found later on in the other areas just mentioned. It can spread to the face and diaper area as well, and when it does happen, pediatricians call it seborrheic dermatitis (because it occurs where there are the greatest number of oil-producing sebaceous glands). Seborrheic dermatitis is a non-infectious skin condition that is very common in children, usually starting in the first few weeks of life and slowly resolving over a period of weeks or months. Unlike eczema or contact dermatitis, it is rarely uncomfortable or irritating.

What is the cause of cradle cap?

No one knows for sure the exact cause of this rash. Some doctors have speculated that it may be influenced by the mother's hormonal changes during pregnancy, which stimulate the child's sebaceous glands. This over production of oil may have something to do with the scales and the red area of the skin.

What is the treatment for cradle cap?

If your baby's seborrheic dermatitis is confined to her scalp (and therefore only cradle cap), you can treat it yourself.

• Don't be afraid to wash her hair; in fact: you should wash it (with a mild baby shampoo) more often than before. This, along with a soft brush, will help remove the scales. Stronger medicated shampoos (anti-seborrheic shampoos containing sulfur and 2 percent salicylic acid) may loosen scales faster, but since they can also be irritating, use them only after consulting your pediatrician.
• Some parents have found that petroleum jelly or ointments may be beneficial. But baby oil is not very helpful or necessary. In fact, although many parents tend to use unscented baby oil or mineral oil and nothing else, doing so allows flakes to build up on the scalp, particularly over the soft spot on the back of the head or fontanel.
• Your doctor may prescribe a cortisone cream or lotion, such as 1 percent hydrocortisone cream. Once the condition improves, you can prevent it from happening again, in most cases, by continuing to wash your hair frequently with a mild baby shampoo.

Fungal/Yeast Infection:

Sometimes yeast infections occur on the affected skin, most likely in the fold areas rather than the scalp. If this happens, the area will become extremely red and it will be annoying. In this case, your pediatrician may prescribe a medication such as an antifungal cream.

Forecast:

You can be sure that seborrheic dermatitis is not a serious condition or infection. Neither is it an allergy due to something you use or due to poor hygiene. It disappears without leaving any scar.