SOS : My baby’s head is all crusty

Dre. Emilie Bourgeault

Tuesday, January 11, 2022

What are those yellow flakes that cover my baby’s scalp? Is it a serious condition? Is there something I can do?

This article was prepared in collaboration with Marie Fortier, a nurse who specializes in pre- and post-natal care, and focusses on seborrheic dermatitis, most commonly known as “cradle cap”.

What is seborrheic dermatitis or cradle cap?

  • Don’t worry: infantile seborrheic dermatitis is a very common transitory disorder in infants and it is not dangerous. It can come and go spontaneously.

  • It is characterized by yellowish flakes or scales on a backdrop of pinkish greasy skin. It usually appears on the scalp but can also affect the face, neck, abdomen and even the diaper area.

  • It normally starts one week after birth and can last at least three months.

  • When the skin is significantly affected, there can be associated itching.

What is the cause?

The cause of cradle cap includes an overproduction of sebum (fat secretions) by the sebaceous glands of the skin and a contamination of these areas by Malassezia, a benign microscopic skin fungus. This fungus growth is in turn responsible for the formation of flakes and crust as well as pinkish patches on the skin.

What can I do if my baby has cradle cap?

  1. BAIN

    • Give a 5-minute lukewarm bath to your baby every day. Rinse and dry well.

    • Use a gentle soap and shampoo.

    • Apply an unscented moisturizer after the bath.

  2. CLOTHING

    Make sure your baby’s head is not excessively covered in order to avoid the scalp overheating and getting sweaty.

  3. WHAT IF IT DOESN’T GO AWAY…

    In persisting cases, we can use an antifungal cream like ketoconazole 2%. A low-dose cortisone topical cream, such as hydrocortisone 1%, is often recommended alongside. Ketoconazole is also found as a shampoo (Nizoral) for babies with lots of hair – but watch out for the little eyes!

  4. AND WHAT ABOUT THE FLAKY CRUST?

    • To remove the crust, it is suggested to apply a mineral oil (for instance with salicylic acid 6%) 15 minutes before shampooing. This helps soften superficial crust.

    • After shampooing, comb the baby’s scalp with a fine-tooth comb to delicately remove the flakes.

    • Be gentle and avoid rubbing too much as it can hurt the baby.

    • In the presence of scales and flakes over a large area of the body, consult with a professional.

For any questions related to your personal situation, you can ask advice from our certified dermatologists at dermago.ca.

This article is adapted from a post written in collaboration with Marie Fortier (French only).

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