Medicines for Cradle cap

What it is

Cradle cap is a very common, harmless skin condition affecting babies, in which greasy, yellowish or brownish scales or crusts appear on the scalp. It usually develops in the first few weeks or months of life. The scales can be patchy or cover much of the scalp, and the skin underneath may look slightly red; it can sometimes also affect other areas such as the eyebrows, behind the ears, the nappy area, or skin folds. Cradle cap is thought to be related to the activity of the skin’s oil glands in early life, possibly influenced by hormones passed from the mother, and sometimes by a harmless yeast that lives on the skin. Importantly, cradle cap is not caused by poor hygiene, is not an infection that spreads, and is usually not itchy or sore, so it does not generally bother the baby. It is a normal, self-limiting condition that almost always clears up on its own, usually within weeks to a few months, and typically by the time the baby is around a year old. Because it looks different from healthy skin, it can worry parents, but it is harmless. Reassurance and simple measures are usually all that is needed. Occasionally, if the skin becomes very inflamed, widespread, itchy, or shows signs of infection (such as weeping, swelling, or spreading redness), or if the diagnosis is uncertain, it is worth seeking advice to confirm the cause and consider treatment.

How it is treated

Cradle cap usually needs no medical treatment and clears on its own, so management focuses on gentle care and, if desired, simple measures to help loosen and remove the scales. Helpful measures include: washing the baby’s hair regularly with a mild baby shampoo and gently massaging the scalp; softening the scales before washing by gently massaging in a small amount of a suitable emollient or baby/natural oil (for example, applying it, leaving it for a while, then gently brushing with a soft brush and washing off), which helps loosen the crusts; and using a soft brush or cloth gently to help lift loosened scales during or after washing. It is important not to pick or scratch at the scales, as this can irritate or damage the skin and risk infection. If simple measures are not helping, or the cradle cap is very thick, widespread or troublesome, a pharmacist or GP can advise — sometimes a specific shampoo or cream is recommended. The reassuring messages for parents are that cradle cap is common, harmless, not due to poor hygiene, not usually itchy or uncomfortable for the baby, and almost always clears up on its own, usually within weeks to a few months. Advice should be sought if the skin becomes inflamed, itchy, weepy or infected-looking, spreads significantly, or if there is any uncertainty, so the cause can be confirmed and any treatment considered.