Cradle Cap (Infant Seborrhoeic Dermatitis)
What cradle cap is, why it's harmless, and how to soften and remove the scale without damaging skin.
- Last reviewed
- Sources cited
- 4 sources
- Author
- Dr Jubal John, FRACP
- Category
- medical guides
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Take-home
Cradle cap is harmless, common (peak prevalence ~70% at age 3 months, falling steadily through the first year), and self-limiting: most cases settle without any treatment by age 1. It is not caused by poor hygiene, allergy, or anything the parent did. Gentle oil-soak, soft brushing, and a mild baby shampoo are all most babies need. Scratching or vigorous scrubbing makes it worse.
What cradle cap is
Cradle cap is the infant version of seborrhoeic dermatitis. It shows up as:
- Yellow or greasy scales on the scalp
- Sometimes red, slightly scaly patches on the face (eyebrows, behind ears), neck folds, and nappy area
- No itch or only mild discomfort, unlike eczema, babies usually don’t seem bothered
The likely mechanism is an overreaction to normal skin yeast (Malassezia) in oily areas, in a baby whose sebaceous glands are still receiving maternal hormones. As the hormonal influence fades in the first year, the rash fades with it.
What it isn’t
Cradle cap vs other things it looks like
- Eczema: itchy, red, dry, often on cheeks and limbs, family history of atopy. Needs active eczema care (see Eczema Management).
- Tinea capitis (ringworm): circular patches with hair loss. Needs oral antifungal; unusual in infants.
- Psoriasis: silvery scales, sharply demarcated plaques. Rare in babies.
- Scabies: itchy, widespread, involves palms and soles, often multiple household members affected. Needs permethrin.
If there’s doubt, book a brief review (photos of how it’s changed help).
The gentle routine that works
Step-by-step
- Soak the scale: massage a small amount of baby oil, almond oil, or even olive oil into the scalp 20–30 minutes before bath. Some families leave it overnight.
- Bath time: wash with a mild, fragrance-free baby shampoo. Work it in gently.
- Soft brush: a soft-bristled baby brush over the dampened scalp lifts the loosened scales. Work in one direction. Don’t pick.
- Rinse + pat dry: rinse well, pat dry, don’t rub.
- Repeat: every 2–3 days while the scale is there. Not every day (can irritate).
Most families see improvement in a week or two. Full resolution can take a few months, that’s normal.
When over-the-counter shampoos help
If the routine above isn’t shifting it after 2–4 weeks, or the scales are thick, ask a pharmacist about:
- Ketoconazole 2% shampoo: used 1–2 times a week, short contact (1–2 min), rinsed off
- Selenium sulphide shampoos: occasionally recommended in stubborn cases
Both are safe in infants when used correctly, but ask first if under 6 months. Avoid getting medicated shampoo in the eyes.
Tar-based shampoos and salicylic acid shampoos are generally avoided in young babies.
Cradle cap on the face and nappy area
Seborrhoeic dermatitis can appear on:
- Eyebrows
- Behind the ears
- Nasolabial folds (sides of nose)
- Nappy area (red, greasy, in the folds, see Nappy Rash)
For these areas:
- Gentle cleansing with water, don’t scrub
- Hydrocortisone 1% cream for 3–5 days if it’s red and looks inflamed (ask us or your GP before using steroids on face)
- Barrier cream where needed
When to seek help
Green — usually fine
Green: manage at home
- Scaly yellow patches on scalp, baby otherwise well, no itch, no redness spreading
- Gradual improvement with gentle routine
Amber — be alert
Amber: book a review
- Not improving after 4–6 weeks of consistent gentle care
- Spreading to large areas of the body
- Itchy or inflamed (may be eczema, not cradle cap)
- Hair loss in a circular pattern (rule out tinea)
Red — act now
Red: seek same-day review
- Fever or unwell baby with a rash
- Weeping, crusting, pus or spreading redness suggesting infection
- Rash plus blistering, peeling, or loss of skin
Common questions
“Will it leave scars or hair loss?”
No. Cradle cap doesn’t damage the skin or hair follicles when managed gently. Picking or scrubbing can cause hair loss, which grows back, so the rule is “soak and lift”, not “peel”.
“Is it contagious?”
No. It’s not caused by infection and doesn’t spread between babies.
“Does it mean my baby will have eczema?”
Not necessarily. Many babies with cradle cap have no other skin issues. Some do go on to develop eczema, but cradle cap itself isn’t a predictor.
“Can I just leave it?”
Yes. Many families do, and it resolves anyway. Active management is cosmetic + comfort, not medical necessity, with the exception of very extensive or inflamed cases.
“Is there a diet or formula change that helps?”
No reliable evidence. Cradle cap isn’t caused by what a baby (or breastfeeding parent) eats.
Related reading
Not sure if it's cradle cap or eczema?
Your GP or MCH nurse can usually settle it, the look-alikes need very different care.