An 8-week-old baby girl is brought in to see her GP because her parents are concerned about the appearance of her scalp. She has a thick crusty rash evident, which is shown above.
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This baby has seborrhoeic dermatitis, which is more commonly referred to as cradle cap. It generally starts in the first few weeks of life, and most cases begin to resolve at three months, and it rarely persists past eight months.
The signs of cradle cap include:
- Reddening of the skin
- Greasiness of the skin
- Yellow crusts
- Thick scales or flakes on the scalp
It most commonly affects the scalp but can also occur in the nappy area, face, chest, back and limb flexures.
The child will be otherwise well and is usually not distressed by the presence of the rash.
2. What is thought to be the cause of this condition?
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It is a common skin condition in babies that is thought to be caused by overactive sebaceous glands. It has also been hypothesised that a fungal infection may be implicated.
3. What treatment would you recommend?
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Treatment is dependent upon the severity of the rash. Often no treatment at all is required, and the rash settles very rapidly. Mild to moderate cases can be treated by massaging olive oil or baby oil into the scalp prior to the use of a mild baby shampoo. In cases that fail to settle, ketoconazole shampoo can be used as a second-line agent. Topical steroids, such as 1-2% hydrocortisone, are used in severe cases.
Header image used on licence from Shutterstock
