Cradle cap
Cradle cap is the yellowish, greasy scale that forms on a baby's scalp in the first months of life.
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Medicines commonly prescribed for Cradle cap
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: CREAM, 20 mg/gActive substance: ketoconazoleManufacturer: Kern Pharma S.L.Prescription requiredDosage form: GEL, Ketoconazole 2%Active substance: ketoconazoleManufacturer: Laboratorios Cinfa S.A.Prescription requiredDosage form: GEL, 2% GELActive substance: ketoconazoleManufacturer: Qualix Pharma S.L.Prescription required
Cradle cap
Cradle cap is the yellowish, greasy scale that forms on a baby's scalp in the first months of life. It does not itch, does not bother the baby, is not an allergy and has nothing to do with hygiene or the mother's diet. It is infantile seborrhoeic dermatitis and it clears on its own, usually before the first birthday. The only thing to avoid is making it worse by trying to remove it too quickly.
How it looks
- yellow or brown scales and crusts with a greasy appearance, stuck to the scalp;
- the skin underneath may be slightly pink;
- a little hair sometimes comes away with a crust — it grows back without problem;
- it can extend to the eyebrows, the sides of the nose, behind the ears, the neck and the skin folds;
- in the folds it looks more like red shiny areas than scale;
- the baby does not scratch and is settled — this is the main difference from atopic dermatitis, where itching dominates;
- it starts between two weeks and three months and usually resolves between six and twelve months.
Why it happens
Maternal hormones passed to the baby late in pregnancy stimulate the baby's sebaceous glands during the first months. The Malassezia yeast, a normal skin resident, multiplies on that sebum and the skin responds with scaling. Once the hormonal effect fades, the process settles by itself.
What to do
- soften before removing: apply a vegetable oil — olive or sunflower — or petroleum jelly to the crusts and leave for 20 minutes to an hour;
- then wash the head with a mild baby shampoo and gently lift the loosened scale with a very soft brush or fine comb;
- do not pick off adherent crusts: forcing them away breaks the skin and creates a risk of infection;
- wash the head daily or every other day while it lasts;
- rinse thoroughly: leftover oil keeps the problem going;
- in the folds, keep the skin dry and use a barrier cream;
- do not use nut oils, because of the risk of sensitisation.
If that is not enough
- shampoos with a mild antifungal, prescribed by your doctor;
- ketoconazole cream for the face and folds;
- a very mild steroid in a short course if inflammation is marked, on medical advice only;
- treatment of any added fungal or bacterial infection.
When to see a doctor
- the baby is scratching, unsettled or sleeping badly — this is more likely to be atopic dermatitis than cradle cap;
- the skin is red, hot, weeping, smells unpleasant or has pustules — infection;
- the rash is spreading over much of the body;
- there is no improvement after several weeks of care;
- there are patches of hair loss with scaling in defined areas — ringworm needs to be excluded;
- the baby is not gaining weight or has diarrhoea alongside the rash;
- small red spots appear that do not fade when pressed;
- it has started after 12 months of age.
Cradle cap or atopic dermatitis
This is the most common question, and it comes down to two things: itching and location.
- cradle cap: greasy scale on the scalp and in the folds; the baby does not scratch; it starts very early;
- atopic dermatitis: dry, red, itchy skin; in infants it affects the cheeks and the outer surfaces of arms and legs; the baby rubs and sleeps worse; it usually starts a little later.
Common questions
Is it contagious? No.
Is it related to the mother's diet? No. There is no need to change the maternal diet because of this.
Can I comb the crusts out dry? Better not: you drag healthy skin with them. Soften first.
Will the hair grow back? Yes, completely.
Can it come back later? Seborrhoeic dermatitis or dandruff can appear in adolescence, but that is a different stage and context.
Should the head be washed every day? During the episode, yes; afterwards, at your usual frequency.
Online consultation
In an online consultation the doctor reviews photographs, helps distinguish cradle cap from atopic dermatitis and from infection, explains step by step how to soften and lift the scale without damaging the skin, and advises when adding an antifungal shampoo makes sense.
This material is for information only and does not replace a medical consultation.
Medically reviewed by
Reviewed on Jul 21, 2026
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