What Really is Cradle Cap?

Written on: Jan 27, 2019
By: Shari Hicks-Graham

Both of my children had dry scalp as newborns. As a new parent, it was frustrating because I knew that I was doing everything in my power to care for them and keep them clean. Despite my efforts, the flaky scalp build-up returned day after day. Fortunately, it didn’t seem to bother my babies at the time, but it was frustrating until I gave my maternal instincts a boost by tapping into my expertise as a dermatologist. It’s understandable to be confused or concerned that your healthy, beautiful baby has what seems to be dandruff?! We rarely see infants in dandruff shampoo commercials so we are not quick to associate this condition with infants but it happens. People often call this condition “cradle cap” or baby dandruff. The medical term is seborrheic dermatitis. Cradle cap typically resolves on its own with time, but it may also become a relapsing and remitting condition over the years. Generally speaking, this condition is harmless and should not be a cause for concern in infants. Regardless, I will share some basic ideas to help understand the best way to manage cradle cap.

Cradle cap may be identified by flaky, scaly, white or yellow debris on the scalp of your baby soon after he or she is born. It is a common condition found in 10 percent of all infants. However, the condition is not just unique to babies! Lots of older children and adults also suffer from the same bothersome symptoms as cradle cap. Although the precise reason for cradle cap is unclear, we know that when babies are born, their normal bacterial flora may not be as well developed, which may allow more yeast (particularly Malassezia) to grow and contribute to this flaky scale. Additionally, maternal hormones from birth can add to the development of this yeast by stimulating more sebum onto the skin. Typically, with time, the baby outgrows the condition; however, many older children and adults continue to struggle with dandruff to varying degrees.  

Thankfully, treatment of cradle cap is fairly simple. First, be gentle when handling the scalp. There is no benefit in aggressively scrubbing or scratching a flaky scalp, in fact, this may aggravate the skin and cause damage or risk for further infection. Next, cleanse the scalp with a mild shampoo. For infants, we recommend something tear-free and appropriate for their age that has no harsh surfactants, which may overdry the skin and cause more irritation. Of course, consistency is key. It is better to be gentle with regular treatment than aggressive and sporadic with the shampoo regimen. Use a soft washcloth to gently massage the shampoo into the scalp and rinse well with warm water. Cradle cap can often be effectively managed by shampooing twice weekly. If shampooing twice per week over the course of  a few weeks proves to be insufficient in managing the condition, then a doctor may prescribe an antifungal shampoo like ketoconazole or even a low-potency hydrocortisone cream for a limited period of time. After each shampooing regimen, it is important to ensure that the scalp dries well to prevent having a damp environment where yeast may thrive, offsetting your efforts to resolve the issue.

Infancy is a special time for both a parent and a child and we always want to have the best information to help our children be healthy and comfortable. Remember, there will always be some uncertainty during an infant’s life and some challenges may arise, but if you see some symptoms that seem like cradle cap on your infant, there is no need to panic. The condition is quite manageable and the condition is not necessarily an indication of the overall health or hygiene of your baby. When in doubt, consult a board-certified dermatologist for a more thorough evaluation of the condition. We are inspired with the opportunity to serve and be a resource to you along the way as you LivSo healthy and free.  


Shari Hicks-Graham, MD