cradle cap
| Dictionary: cradle cap |
n.
A form of dermatitis that occurs in infants and is characterized by heavy yellow crusted lesions on the scalp.
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| Alternative Medicine Encyclopedia: Cradle Cap |
Definition
Cradle cap is a form of seborrheic dermatitis, a minor inflammatory disease of the scalp, face, and occasionally other areas of the body. It is a common scalp problem in infants and younger children.
Description
Cradle cap appears as thick, oily yellowish or brownish patches on the skin, particularly the scalp. It is also often found around the eyebrows, around the nose, behind the ears, and in the genital area. The skin itself often appears to be red, flaky, and irritated underneath the oily patches. It most often effects children who are between two weeks and two years old. Although cradle cap may be unsightly, it is usually not harmful to the child.
Causes & Symptoms
During infancy and early childhood, the glands that produce sweat and oil are in a highly reactive state. Cradle cap is most likely due to a buildup of sweat and oil produced by these overactive glands. This buildup may also cause an irritation of the skin. Sometimes an over-growth of the yeast called Pityrosporum ovale may also contribute to the condition. Occasionally, cradle cap is a symptom of more serious problems.
Diagnosis
Cradle cap is easily recognizable, and usually it requires no further diagnosis. However, if the rash seems to be very itchy or irritating, it may be necessary to rule out eczema. If there are additional symptoms, a health-care provider should be consulted for a physical exam and possible testing.
Treatment
Most remedies for cradle cap can be applied directly to the oily patches on the skin. Tannins, for example, can help to slow down oil production, as well as clear away the cradle cap. Warm caffeinated tea, German chamomile tea (Matricaria recutita), burdock tea (Arctium lappa), or diluted witch hazel extract (Hamamelis virginiana,) can be rubbed into the skin with a cloth several times per day.
A comfrey rinse can also be used. It should be rubbed onto the affected area with a washcloth. The rinse can be used after shampooing or bathing, or it can be applied to dry skin. This treatment can be given nightly for up to ten days until the symptoms are gone. The comfrey rinse can be made by boiling two ounces (about 57 grams) of comfrey root, Symphytum officinale, in one quart (or one liter) of water. The tea should be simmered for 20 minutes and then allowed to cool. A batch of the comfrey rinse can be used and stored in the refrigerator for up to four days.
A rule of thumb in science is that like dissolves like; therefore, any type of food grade oil can be used to dis-solve the oily buildup found in cradle cap. Olive oil, wheat germ oil, and sesame oil are particularly favored. Aromatherapy may be used by adding in 1-2 drops of the essential oil of lavender, Lavandula angustifolia. The oil should be applied to the skin and left overnight. It can then be removed gently and slowly with a baby brush or a fine-tooth comb. The area should be washed or shampooed afterwards with a very mild soap.
Slippery elm (Ulmus fulva) is useful in soothing a variety of skin problems, and can be applied to affected areas several times per day. The herb can also be misted liberally with water or used as a tea. Ointments containing Calendula offinalis or plantain (Plantago major) are also appropriate to use on areas of cradle cap. These herbs can often clear up an outbreak in as little as four days.
Internal remedies for cradle cap can be quite effective. These include tincture of burdock root, which can help to balance oil and sweat production. Burdock is also a good general tonic to take to keep the skin healthy. Burdock should be given for at least three weeks for full effect. A tincture of the wild pansy flower, Viola tricolor, can also be given. Biotin, a B vitamin, works well for cradle cap and can be given at dosages of 10 micrograms (mcg) for age 0-6 months; 15 mcg for age 6-12 months, and 20 mcg for age one to three years.
Allopathic Treatment
Generally, cradle cap does not need to be treated medically. If the condition is resistant to treatment or it starts spreading, however, an over-the-counter dandruff shampoo may be used once per day until the cradle cap has improved. Shampoos containing coal tar derivatives may be highly irritating and are not recommended for use on children under two.
A 0.5% or 1% hydrocortisone cream is available over-the-counter and can be applied two or three times per day to stubborn cases of cradle cap. If a Pityrosporum ovale infection is suspected, a dermatologist may prescribe ketoconazole (Nizoral) cream or shampoo. These medications are strong and should be used for as short a time as possible.
If crusting, pus, redness, or pain are present, a physician should be consulted. There may be an underlying infection caused by the infant's scratching, which can introduce bacteria into the skin. Antibiotics may have to be prescribed. Other symptoms, such as poor growth or diarrhea may point to immune system problems requiring medical assessment and treatment.
Expected Results
Usually cradle cap will eventually resolve with no aftereffects, even without treatment. However, it can take quite some time to clear. Most home remedies should clear up cradle cap in a few weeks or months.
Prevention
Washing the hair more often than two or three times per week may dry the skin out, making it more vulnerable to cradle cap, so limited hair washing is recommended.
Resources
Books
Foley, Denise, et al. The Doctors Book of Home Remedies for Children: From Allergies and Animal Bites to Toothache and TV Addiction, Hundreds of Doctor-Proven Techniques and Tips to Care for Your Kid. Emmaus, PA: Rodale Press, 1999.
Kemper, Kathi J., M.D. The Holistic Pediatrician. New York: HarperPerennial, 1996.
Other
DermaMed Pharmaceutical Incorporated. http://www.dermamed.com/aboutscalp.htm (January 17, 2001).
Health World Online. http://www.healthy.net/asp/templates/book.asp?PageType=Book&ID=787 (January 17, 2001).
[Article by: Patience Paradox]
| Medical Dictionary: cradle cap |
n.
A form of dermatitis that occurs in infants and is characterized by heavy, yellow, crusted lesions on the scalp.
| WordNet: cradle cap |
Note: click on a word meaning below to see its connections and related words.
The noun has one meaning:
Meaning #1:
a dermatitis of the scalp that is common in infants
| Wikipedia: Cradle cap |
 |
This article does not cite any references or sources. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (April 2009) |
| Cradle cap | |
|---|---|
| Classification and external resources | |
 An infant with Cradle Cap |
|
| ICD-10 | L21.0 |
| ICD-9 | 690.11 |
Cradle Cap (infantile or neonatal seborrhoeic dermatitis, also known as crusta lactea, milk crust, honeycomb disease) is a yellowish, patchy, greasy, scaly and crusty skin rash that occurs on the scalp of recently born babies. It is usually not itchy, and does not bother the baby. Cradle cap most commonly begins sometime in the first 3 months. Similar symptoms in older children are more likely to be dandruff than cradle cap. The rash is often prominent around the ear, the eyebrows or the eyelids. It may appear in other locations as well, where it is called seborrhoeic dermatitis rather than cradle cap. Some countries use the term pityriasis capitis for cradle cap. It is extremely common, with about half of all babies affected. Most of them have a mild version of the disorder. Severe cradle cap is rare.
Contents |
Causes
The cause of cradle cap is not clearly defined but it is not caused by an infection, allergy nor from poor hygiene. Possibly it has to do with overactive sebaceous glands in the skin of newborn babies, due to the mother's hormones still in the baby's circulation. The glands release a greasy substance that makes old skin cells attach to the scalp as they try to dry and fall off. There may be a relationship with skin yeasts (Pityrosporum ovale, newly renamed Malassezia furfur). Nutritionally oriented practitioners have speculated that the disorder is caused by the baby's immature digestive system being unable to absorb sufficient biotin and other vitamins of the B-complex.
Warning signs
Home remedies are appropriate with mild cases. If the condition thickens, turns red and irritated, starts spreading, appears on other body parts, or if the baby develops a persistent diaper rash, medical intervention is recommended. Fungal infection (tinea capitis) and scabies can mimic cradle cap.
Cradle cap is occasionally linked to immune disorders. If the baby is not thriving and has other problems (e.g. diarrhoea), a doctor should be consulted.
Prognosis
Assurances that this condition will clear as the baby matures are very common. However, studies[citation needed] have shown that the condition occasionally persists into the toddler years, and less commonly into later childhood. It tends to recur in adolescence and persists into adulthood. In an Australian study, about 15 percent of previously diagnosed children still had eczema 10 years later. Sometimes, cradle cap turns into atopic dermatitis. Rarely, it turns out to be misdiagnosed psoriasis[citation needed].
Treatment
Scalp, behind ears, eyebrows
The common advice of applying oil (vegetable, particularly olive oil, or mineral oil) liberally to the scalp and letting it soak in overnight or for lesser periods of time seems to conflict with the fact that Malassezia yeasts thrive in oily environments, although anecdotal reports suggest it may be effective. If the cradle cap is not severe, you may try to comb it out gently after bathing. The softened scales can then be brushed away with a soft brush, comb or cloth, but if not done very gently, this can worsen the condition and bring about temporary hair loss. There has been no study done on these recommendations.
Applying petroleum jelly (e.g., Vaseline) liberally overnight is another popular treatment. The softened scales either fall off during the night, or can be brushed off in the morning.
Making a paste from sodium bicarbonate (baking soda) and leaving it on the affected area for 10 minutes can also help lift the scales.
There is broad disagreement regarding the role of shampoos. Some sources warn against frequent shampooing, others recommend it. Mild baby shampoo is often recommended, while never specifying what "mild" actually means. Baby shampoos often contain detergent surfactants, perfumes, quaternium-15 and other eczemagenic irritants. Again, no studies have been performed.
Keratolytic (dandruff) shampoos (e.g with sulfur, selenium, zinc pyrithione, or salicylic acid) are generally not recommended as they sting eyes and may worsen the dermatitis. In stubborn cases some doctors do recommend them while others warn against the use of medicated shampoos in newborns due to systemic absorption. Dandruff shampoos often contain sodium dodecyl sulfate, a noted skin irritant.[1]
Steroid and tar preparations have also been used but have significant drawbacks. Immunomodulators (tacrolimus/Protopic, pimecrolimus/Elidel) have not been approved for babies under two years.
Ketoconazole shampoos and creams are taking first place in medical treatment of moderate to serious cradle cap. Research so far indicates that this anti-fungal medication is not absorbed into the bloodstream. Ketoconazole shampoo is currently made with a number of problematic irritants and allergens.
A Swedish study[citation needed] found good results from massaging the scalp with small amounts of borage oil twice a day. # Tolleson, A., and Frithz, A. 1993. Borage oil: an effective new treatment for infantile seborrheic dermatitis. Brit. J. Dermatol. 129:95.
Other home remedies recommended in various alternative sources and parent forums are herbal washes (e.g burdock or chamomile), aloe gel, and tea tree oil (Melaleuca oil) shampoo. Tea tree oil and aloe can be sensitizers; any worsening should be an occasion to discontinue the remedy in question. Both remedies have been tested in medical trials and found useful.[citation needed]
Eyelids
Typical medical advice is to use diluted baby shampoo on a cotton swab to cleanse the eyelid. There is no agreement on the dilution, which ranges from a few drops to a half cup warm water, to a 50/50 mix. No studies have been performed on the efficacy or safety of this treatment. (Please note the problems with baby shampoo noted above.) In adults, a study comparing soap and baby shampoo to commercial eyelid scrubs found that patients strongly preferred not to put soap or shampoo on their eyelids. Baking soda has also been recommended (a teaspoonful in a cup of boiled water) and is well accepted by adults. Boiled warm water wash may help.
References
- ^ "Fact Sheet: Cradle cap". Better Health Channel. Victorian Government, Australia. April 2006. http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Cradle_cap?OpenDocument. Retrieved 2006-07-14.
External links
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