Introduction:
A cradle cap is a form of dandruff in infants characterized by brittle or greasy scaly patches on the scalp. It is not a contagious condition and usually does not cause pain or itching, but thick white or yellow scales that cannot be removed easily are present. The cradle cap usually fades in weeks or months. However, a few simple steps can help relieve the problem. A cradle cap is named after the scaly patches that are usually present on the head where a cap is worn.
What Is a Cradle Cap Otherwise Called?
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Pityriasis capitis.
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Seborrheic dermatitis of infants.
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Infantile seborrheic dermatitis.
What Causes Cradle Cap?
The exact reason for the cradle cap is not known. However, the following reasons are thought to be the cause of cradle caps. They are:
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When the frequency of cradle caps increases during infancy and adolescence, it might be due to genetic inheritance of a specific hormone from the mother. This hormone produces excess oil from the oil-producing glands resulting in skin cell death. Overproduction of oil makes the dead scales stick to the scalp instead of undergoing average skin peeling.
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Malassezia furfur (Pityrosporum ovale) is a fungal and bacterial infection of the skin oil. The fungus breaks down scalp oil, consumes the saturated fatty acids, and leaves the unsaturated fatty acids. M. globosa and M. restricta are the fungi involved in the cradle cap. The cradle cap is not contagious and is not an effect of poor hygiene.
Who Is Affected by Cradle Cap?
It is commonly seen in early infants. Both males and females are affected. The cradle cap attains its peaks at three months of age and then decreases progressively as the infant reaches one year of life. Seven percent of children are affected with mild infection during the second year of life and decrease further during the fourth year of life. Cradle caps can be expected in infants whose family members are affected with eczema or asthma. Cradle caps are more prevalent in diseases like HIV (human immunodeficiency virus)-infected patients and neurological disorders.
What Are the Signs and Symptoms of Cradle Cap?
The cradle cap looks like the following:
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White, yellow, or red; oily or wet patchy scales or thick crusts on the scalp.
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The scales may chip off over time.
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They are red and wet in skin creases and folds.
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Scales present on the forehead and face, eyelids, nose, behind the ears, diaper area, umbilical area, armpits, groin, and other skin folds and creases.
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A cradle cap is commonly present in newborns between two weeks and 12 months.
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It is usually not itchy.
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In rare cases, hair loss has been seen. But the hair regrew once the lesion regressed.
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In rare cases, the condition can present as an erythrodermic eruption. In this situation, the clinician should consider immunodeficiencies and vitamin deficiencies.
How Is Cradle Cap Diagnosed?
Healthcare professionals diagnose cradle cap with a simple clinical examination. No laboratory investigations or biopsies are required.
How Is Cradle Cap Treated?
The cradle cap usually disappears in a few weeks or months.
Other treatments of cradle cap are:
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Wash baby's hair daily with mild, tear-free baby shampoo. Subsequently, decrease shampooing to twice weekly.
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Do not use any anti-dandruff shampoos.
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Gently brush the scales on the hair and scalp with a soft brush or toothbrush to remove them.
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If the scales are heavy, apply some petroleum jelly, olive oil, baby oil, or ointment to the scales on the scalp and wrap a warm, wet cloth over it. Leave it for a few minutes or hours. Use a soft hairbrush or toothbrush to remove scales and shampoo the baby's hair.
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Many treatments for cradle caps for adults are adopted for use for infants. These include topical antifungals, anti-dandruff shampoos with zinc pyrithione or selenium sulfide, coal tar preparations, and episodic topical corticosteroids.
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When signs of infection and inflammation of the scalp like fever, pain, any discharge, red, foul odor, pimples, or blisters are seen it is advised to consult a doctor. The doctor may prescribe a steroid cream or antifungal shampoo in such a case. It is recommended to use these with a doctor's prescription.
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Antibiotics may be prescribed when there is an infection of the scalp.
What Are the Natural Treatments for Cradle Cap?
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Fish Oil Supplements - Consuming Omega-3 fatty acids is advised for full immune function. Fish oil supplements help to decrease flare-ups in cradle cap efficiently.
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Aloe Vera - Aloe vera gel contains natural anti-inflammatory properties to treat cradle caps.
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Tea Tree Oil - Mix eight to twelve drops of tea tree oil with coconut oil or olive oil and apply this to the affected location. This reduces itching while healing the flaky spots on the scalp.
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Apple Cider Vinegar - Soak the scales on the scalp in apple cider vinegar to loosen them and wash them off with mild shampoo. Apple cider vinegar also has anti-inflammation effects.
When to See a Doctor for Cradle Cap?
The doctor should be consulted:
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If the condition does not improve in a few months.
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Baby’s scalp feels hot while touching.
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Crusted skin has blood or fluid leaking.
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Scales and rashes appear red and swollen.
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Baby’s scalp skin smells bad.
How Is Cradle Cap Prevented?
The following preventive measures can help manage the cradle cap,
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First, do not scratch or pick the scales.
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Shampoo the baby's hair with a mild baby shampoo every few days.
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When the cradle cap comes under control, keep washing the baby's hair and brush the scalp with a soft, gentle hairbrush.
What Are the Differential Diagnosis for Cradle Cap?
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Atopic dermatitis (a condition causing itchy, dry, and inflamed skin).
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Impetigo (a contagious infection that causes sores on the face).
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Tinea capitis (fungal infection occurring in the scalp hair).
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Diaper dermatitis (bright red and inflamed buttocks skin).
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Langerhans cell histiocytosis (a condition causing excess build-up of immune system cells).
What Are the Complications of Cradle Cap?
Coinfection with bacteria is possible in the cradle cap. However, it is a rare complication due to repeated scratching when the scales irritate.
Conclusion:
The prognosis of cradle cap is also quite good, and it may disappear within a few months or years. Cradle cap is the most common, self-limiting, chronic non-inflammatory scaling skin condition seen between the third week to a few months of a newborn. However, if the condition continues even after one year of age, other diagnoses should be investigated. The skin appears as red plaques with a greasy yellow scale. It is common among infants and heals over time. Educating the parents on the management and the nature of this condition is necessary.
