Seborrheic dermatitis, or “cradle cap,” is commonly seen in younger infants, often in the first few weeks of life. Greasy-appearing white or yellowish scales and plaques may cover the entire scalp. Redness and scaling can also involve the eyebrows, the skin behind the ears, and the creases in the neck and armpits. The scales may be thick and difficult to remove and may make combing the infant’s hair difficult. The scalp itself underneath the crusting can become inflamed and reddened.

The cause of cradle cap is not known, although the baby’s exposure to pregnancy hormones probably plays a role. Routine shampooing and massaging of an infant’s scalp twice a week to loosen and remove any crusts usually prevent the condition from becoming a problem. Cradle cap almost always goes away by itself eventually, but this may take several months. If your infant develops severe cradle cap, you can try the following routine:

• Loosen scalp “crusts”: Put warm (not hot) mineral oil, baby oil, cocoa butter, or olive oil on the scalp to help soften the crusts. Massage the scalp well when applying. Leave in for one to two hours, then shampoo.
• Shampoo: When first treating severe cradle cap, use a gentle nonprescription, selenium-containing, antidandruff shampoo once a day. Lather the scalp/hair thoroughly, then use a fine comb, soft brush, or washcloth to massage the scalp and help remove the now-softened crusts. Then rinse completely, massaging the scalp gently, making sure to get out all oils and soap. After about a week, when the cradle cap should be greatly improved, switch to regular baby shampoo and use it twice weekly.

If the scalp is red and inflamed under the scales or if the rash isn’t limited to your baby’s scalp, your child’s doctor may prescribe a mild steroid cream (hydrocortisone) to reduce the inflammation. In a few infants, the inflamed skin beneath the cradle cap becomes infected and antibiotic treatment is required.