Cradle cap is a common condition of infancy in which patches of greasy, yellow flakes and small, pimple like bumps appear on the scalp and, less often, on eyebrows and lashes. Crusts also may develop behind the ears and on the face, neck, chest, buttocks, and other places where sebaceous glands are located. These glands, which produce sebum, a fatty wax-like skin lubricant, are at the heart of the problem. Cradle cap is most likely to appear during the first few weeks of life, and it usually clears up by the sixth month. The cause is unknown, but some dermatologists think that high levels of maternal hormones, which may be transmitted to the baby during the final weeks of pregnancy, trigger the production of excess sebum. This excess not only overstimulates the growth of new cells but also binds the discarded cells together into flakes and crusts. Dermatologists do not believe that cradle cap is related to the adult form of dandruff, nor has it anything to do with infrequent bathing or any other aspect of hygiene or infant care. Contrary to some media reports, there is no evidence either that cradle cap is a sign of a nutritional deficiency.
Other Causes of Crusting Skin
Eczema may produce skin flaking and crusts. Food allergies have also been linked to cradle cap; if the baby is breast fed, the mother’s allergies should also be considered. In some cases, ringworm or another fungal infection might be the cause of skin crusting and hair loss, especially on the scalp.
Diagnostic Studies And Procedures
The yellow patches of cradle cap are clearly visible, and the condition is readily diagnosed during a regular checkup. It is not unusual even for a doctor to make the diagnosis over the telephone, based on the mother’s description of the baby’s scalp.
If cradle cap is not cleared up with simple home care , a doctor may advise the use of a non prescription cream containing 0.5 percent hydrocortisone. (Although this product is available over the counter, it should not be used on a baby unless a doctor specifically recommends it.) For a severe or very stubborn case of cradle cap, a doctor may also recommend a stronger shampoo that is specially formulated to remove scaly crusts. (Strong shampoo, too, should be used only at the suggestion of a physician.) In rare cases, a yeast infection may complicate cradle cap, particularly if the crusts and bumps are under the arms and in the neck creases as well as on the scalp. A superimposed yeast infection will make the affected skin bright red and cause severe itching. Should such an infection develop, a doctor will prescribe an anti-fungal cream.
Massaging the baby’s scalp with olive oil that contains a few drops of 2 percent sage essence will help loosen the crusts. The olive oil should be shampooed out after each treatment, however, to prevent an oily buildup. If the oil is permitted to build up, the condition may actually become worse.
Herbalists recommend preparing a mixture as follows, Steep ¼ cup of dried nettles in 1 cup of boiling water. When the solution cools, strain and add ¼ cup of cider vinegar. Before you massage the mixture all over the baby’s scalp, try a small sample first to make sure that it doesn’t cause any irritation. Be especially careful not to get any of it in the baby’s eyes.
Because cradle cap is likely to get worse with sweating, the baby should be kept cool and dry. A healthy infant does not need to wear a hat outdoors except in cold weather, and the hat should be removed in a heated car, train, or bus. When you tryout a treatment, give it at least three days to work. Then, if you see no improvement, consider abandoning it for a different one. You can shampoo the baby as often as once a day. While shampooing, you needn’t be fearful about rubbing the fontanel, the soft spot that lies between the bones of the skull at the top of the head. Ordinary rubbing will not injure the underlying brain tissue.
Here are a few other home care measures that should be helpful:
- When bathing the baby, lather the scalp lightly with an ordinary baby shampoo and brush the shampoo into the scalp with a soft hairbrush. Let it stay for a minute or so, and rinse off with warm water or wipe off gently with a washcloth.
- Massage baby oil, mineral oil, or petroleum jelly into the baby’s scalp to loosen the flakes, and then shampoo. Rub in the lather with a soft brush, then rinse the scalp thoroughly with warm water. Repeat this treatment three or four times a week.
- Instead of bathing the baby with soap, consider trying one of the soap-less products such as Lowilla cake or Moisture soap. These are also suitable for use on the scalp.
- Gently comb away loose crusts with a baby comb. However, resist the temptation to remove crusts and scales with the tip of a fingernail. When the scales are ready to come off, they don’t have to be picked at or peeled.