Infants, toddlers and older children can get cradle cap, which is sometimes also called dandruff. The condition causes a crusty, scaly scalp also known medically as seborrheic dermatitis. Overactive oil glands are a major contributing factor. Infestations of head lice in grade school-aged children are sometimes confused with dandruff because the empty egg cases or nits look like dandruff.
Dandruff
Dandruff that affects babies and toddlers is called cradle cap though it is a form of seborrheic dermatitis or dandruff. According to research published in the journal “Pediatrics” in 2005 – and contrary to what most doctors are taught in school – the condition appears in older children too. Cradle cap is a temporary, manageable condition and isn’t dangerous or contagious. Patches of scaly, rough and sometimes itchy skin form on the scalp. The crusty scales may also appear on and around the ears, nose, eyelids and groin and inside folds of skin elsewhere on the body.
Family History & Stress
What causes cradle cap isn't known, though researchers speculate that a major contributing factor is an overproduction of skin oil called sebum in the oil glands and hair follicles. Bacteria, yeast or fungus called malessizia can grow in the sebum, incubated by body heat, and cause the irritation that leads to the formation of skin plaques or crust. Having oily skin or hair is a risk factor, along with stress, fatigue and a family history of eczema. Seborrhea can run in families, meaning genes and other conditions that cause cradle cap can be passed from mother to baby before birth. Some researchers believe there may be a hormonal connection to condition.
Other Factors
Males tend to be more susceptible, and have more severe cases, than females. Other factors include obesity, extremely cold, dry weather and a scratch, abrasion or other skin injury. Previous skin conditions – such as acne, rosacea, psoriasis or blepharitis – may also be factors. Personal hygiene is not strongly linked to dandruff but using lotions or other topicals containing alcohol may be. Taking various medications, including interferon-α, lithium and psoralen, greatly increase dandruff risk. Seborrheic dermatitis has also been associated with medical conditions including HIV, epilepsy, heart attack, stroke and Parkinson's disease, though the relationship isn’t understood.
Treatments
For older children, treat flaking and dryness with medicated and over-the-counter dandruff shampoos that contain active ingredients including salicylic acid, coal tar, ketoconazole, resorcin, selenium or zinc. Shampoo daily, vigorously scrubbing and loosening scales with fingers for at least five minutes and rinse thoroughly. Prescription lotions and shampoos are available for severe cases. For infants and toddlers, loosen and remove scales and improve scalp circulation by gently massaging the scalp with your fingers or a soft hairbrush. Shampoo your child’s hair daily with mild baby shampoo while cradle cap remains. Rinse very well. Reduce shampooing to twice weekly after scales disappear. After shampooing brush your child’s hair with a clean, soft brush, and brush several other times during a day.
References
- FamilyDoctor.org; Seborrheic Dermatitis -- What It Is and How to Treat It; December 2010
- SkinCarePhysicians.com; Seborrheic Dermatitis; American Academy of Dermatology
- NIH PubMed Health; Seborrheic Dermatitis; May 2011
- KidsHealth.org; Cradle Cap (Infantile Seborrheic Dermatitis); Jeremy Michel; August 2011
- Pediatrics; Prevalence of Scalp Scaling in Prepubertal Children; Judith V. Williams, et al.; January 2005
