Cradle Cap: A-to-Z Guide from Diagnosis to Treatment to Prevention

Cradle CapIntroduction to cradle cap:

We are constantly making new skin cells at about the rate that we lose old, dry skin cells. The old skin falls off and we usually don’t even notice the process. In many healthy infants, the skin cells on their scalp grow faster than they can fall off, leaving a layer of somewhat crusty, extra skin known as cradle cap.

What is it?

Cradle cap is a crusting and scaling rash found on the scalps of many healthy babies. The sebaceous glands in their skin are hyperactivated often because of mom’s hormones that crossed the placenta just before birth. These glands pump out a greasy substance that keeps the old skin cells attached as it dries.

Cradle cap is a specific timing and location of seborrhea.

Who gets it?

Cradle cap can occur in any baby, and most commonly begins sometime in the first 3 months.

It is not common after the first year of life until the teen years, when hormone levels rise and exuberant growth returns. Teens often have a similar scalp condition, but for them we call it seborrhea (though I think “cradle cap” when I see it, remembering how far they have come).

What are the symptoms?

Your adorable baby develops patchy scales and redness on the scalp, even though the early baby pictures showed beautiful baby skin. The scales may appear cracked, greasy, or even weeping.

The same rash is often prominent around the ear or the eyebrows. It may appear in other locations as well, where it is called seborrheic dermatitis rather than cradle cap.

Is it contagious?


How long does it last?

In most children, cradle cap is gone by 8 to 12 months and often long before that.

How is it diagnosed?

Cradle cap is diagnosed by physical examination. If it has not improved with simple treatment, other diagnoses should be considered and other tests may be necessary.

How is it treated?

Generally, cradle cap does not need to be treated as long as it doesn’t bother you or the baby. Sometimes it itches.

The gentlest treatment is to simply rub a small amount of baby oil onto your baby’s scalp. Avoid using vegetable or olive oil since a yeast named Malassezia thrives on plant-based oils, worsening the problem instead of treating it. (Arch Pediatr Adolesc Med. 2012;166(10):967)

If the cradle cap is especially pronounced, or if your baby is over six months old, you could also wash the hair with a seborrhea shampoo, such as those containing selenium, salicylic acid, or tar. These shampoos don’t have the “no tears” factor, so be careful or your child may not like bath time as much as he or she usually does.

If the cradle cap is especially reddened or inflamed, a small amount of over-the-counter cortisone cream may help.

These measures may be needed, off and on, until your baby outgrows the condition. Nevertheless, if the cradle cap does not respond rapidly to these treatments, be sure to inform your pediatrician.

How can it be prevented?

Preventing the rapid scalp growth and active sebaceous glands of cradle cap is not easy (or desirable). Frequent gentle shampooing may prevent the build up of scales.

Dr. Alan Greene

As a father of four himself, Dr. Greene has devoted himself to freely giving real answers to parents' real questions -- from questions about those all too common childhood conditions to those that address the most recent and rare pediatric illnesses. His answers combine cutting edge science, practical wisdom, warm empathy, and a deep respect for parents, children, and the environment. He is also an electrifying public speaker, and has personally touched many during his talks in North America, Europe, Asia, and the Middle East.

Dr. Greene is a graduate of Princeton University and the University of California at San Francisco. Upon completion of his pediatric residency program at Children's Hospital Medical Center of Northern California he served as Chief Resident. He entered primary care pediatrics in January 1993.

Dr. Greene is the Past President of The Organic Center and on the Board of Directors of Healthy Child Healthy World. He is a founding partner of the Collaborative on Health and the Environment. He also consults for the Environmental Working Group.

In 1995, he launched, cited by the AMA as “the pioneer physician Web site” on the Internet. His award-winning site has received over 80 million Unique Users from parents, concerned family members, students, and healthcare professionals. In addition to being the founder of, he is the Medical Director for HealthTap.

In 2010 Dr. Greene founded the WhiteOut Movement to change how babies in the United States are fed. In 2012 he founded TICC TOCC - Transitioning Immediate Cord Clamping To Optimal Cord Clamping. He is also the founder of KidGlyphs, a free iPhone app that provides a tool for young children to express themselves beyond their verbal skills while teaching them important language skills.

Dr. Greene is the Founding President of the Society for Participatory Medicine and has served as both President and Board Chair of Hi-Ethics (Health Internet Ethics. He is on the Board of Directors for Healthy Child Healthy World, The Lunchbox Project, and The Society for Participatory Medicine. He has also served as an advisor to URAC for both their inaugural and their updated health web site accreditation program. He is a founding member of the e-Patient Scholars Working Group, and a founding board member of the Center for Information Therapy.

Dr. Greene is a regular columnist for Parenting Magazine. He is also the Pediatric Expert for The People’s Pharmacy (as heard on NPR) and Healing Quest (seen on PBS stations). He was the original Pediatric Expert for both Yahoo! and iVillage.

Dr. Greene is the author of Feeding Baby Green (Wiley, 2009), Raising Baby Green (Wiley, 2007), From First Kicks to First Steps (McGraw-Hill, 2004), The Parent's Complete Guide to Ear Infections (People's Medical Society, 1997), and a co-author of The A.D.A.M. Illustrated Family Health Guide (A.D.A.M., Inc., 2004). He is the medical expert for three additional books, The Parent's Soup A-to-Z Guide to Your New Baby, (Contemporary Books, 1998) The Parent's Soup A-to-Z Guide to Your Toddler, (Contemporary Books, 1999), and The Mother of All Baby Books, (Hungry Minds, Inc., 2002).

Dr. Greene is a frequent keynote speaker at important events such as Health 2.0 2011 held in San Diego, CA, IFOAM 2008 (International Federation of Organic Agriculture Movements), held in Modena Italy, the first European Internet health conference, held in Maastricht, the first International eHealth Association Conference, held in Jeddah, and the largest e-Healthcare World Conference, held in Las Vegas, and the first Green Power Baby Shower, held in Hollywood. Dr. Greene also appears frequently on TV, radio, websites, and in newspapers and magazines around the world, including such venues as the TODAY Show, Good Morning America, Fox and Friends, The Dr. Oz Show, CNN, ABC, CBS, and NBC network news, NPR, The New York Times, The Wall Street Journal, USA Today, Time Magazine, Parade, Parenting, Child, Baby Talk, Working Mother, Better Home's & Gardens, and the Reader's Digest.

Dr. Greene loves to think about challenging ideas, he enjoys being where nothing manmade can be seen, and he wears green socks.

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