Q. The top of my 2-month-old daughter's head has a crusty spot, and her skin is flaky near her eyebrows. Her doctor says she has cradle cap and suggests I put oil on her scalp, but it seems the oil is only making things worse. Is there anything else I can do?
A. Cradle cap is a temporary skin condition that is common in infants under 6 months of age. Harmless and painless, it usually starts on the scalp, causing the skin to feel oily and appear slightly scaly and red. In a more advanced form, thick, yellow, greasy scales can occur. If it spreads to other parts of the body -- face, chest, neck, armpits, diaper area, or behind the ears -- your doctor may call it seborrheic dermatitis. Researchers think that the mother's hormonal changes during pregnancy stimulate the sebaceous glands in these areas to overproduce oil.
Cradle cap can usually be cleared up in just a few weeks by shampooing your baby's hair each day with a mild baby shampoo and brushing out the scales. Don't be afraid to gently wash over her soft spot; it's important to clean her whole scalp. And once your baby's scalp improves, her eyebrows should clear up by themselves.
If the scales are tightly attached to her scalp, apply a small amount of mineral oil to soften and loosen the flakes. Do this about an hour before shampooing, and then use a soft brush to remove any scaly patches before you wash her hair. Be sure to clean off the excess oil because it can exacerbate the condition if left on, as you noticed.
For persistent cases, or if the redness and scaling spread to your baby's cheeks, neck, or groin, your pediatrician may recommend the temporary use of a special anti-seborrheic shampoo or a mild cortisone cream. Increased redness and itching in skin areas affected by seborrheic dermatitis can signal a yeast infection, which would require an antifungal medication.