Simple treatments can reduce the symptoms of cradle cap
The caller wanted to know what to do with her son and his hopelessly flaky, greasy and smelly scalp. Could she have been referring to one of those preteen boys who seem so reluctant to get into the shower? No, the mom was asking for advice in treating her little 3-month-old and his full head of hair.
Many skin conditions are difficult to diagnose over the phone, but this situation sounded so much like typical infant seborrhea of the scalp - better known as cradle cap, and more obscurely known as pityriasis capitis - that I was able to give the mom some skin care tips without her having to bundle up the little guy for an office visit.
Seborrhea is a skin condition often seen in the first few months of life. Affected infants usually don't show signs of seborrhea right at birth, but soon thereafter develop areas of yellow flaky skin that somehow manage to look both oily and dry at the same time.
Seborrhea is usually seen on the baby's scalp, but can also move down to the eyebrows, behind the ears and along the sides of the face, as well as some areas of the torso and groin.
While the exact cause of seborrhea is still unknown, researchers at the New Jersey Medical School note that hormonal fluctuations and the growth of a particular species of yeast (Malassezia) are among the factors that have been linked to the development of this common skin condition. In a 2006 review published in the journal American Family Physician, the New Jersey team found that about 10 percent of kids experience seborrhea flares during their early childhood years.
Seborrhea can be seen across the age spectrum, but the condition is known to peak in two specific populations: zero to 3-month-old infants, and 30- to 60-year-old adults.
Experts at the American Academy of Pediatrics (AAP) offer reassurance, explaining that baby cradle cap is a benign condition that generally disappears during infancy without any treatment. If parents don't like those thick scaly scalps, the AAP suggests daily use of a mild baby shampoo with gentle brushing to loosen scales before the final rinse.
A small amount of mineral oil can be applied to more heavily affected areas of the scalp to help lift the scales prior to shampooing. After clearing it with your child's pediatrician, another option for cradle cap management is readily available over-the-counter adult dandruff shampoo.
Other treatments for difficult cases of seborrhea in young and old include topical antifungal and steroid preparations as well as certain specialty and prescription shampoos. Consult your child's doctor for recommendations.
• Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights.