Picking Cradle Cap: Can I Pick My Baby’s Scalp Flakes?

Picking Cradle Cap

To pick or not to pick that is the question.  Many parents have pondered whether or not it is safe to pick their baby’s cradle cap. The short answer is no. We do not recommend picking your baby’s cradle cap. 

What is Cradle Cap?

Most healthcare providers will refer to cradle cap as “cradle cap,” but the actual technical name of this entity is seborrheic dermatitis. Seborrheic Dermatitis is a more intense version of skin flaking than the dandruff you yourself may suffer from.

Cradle cap can cause thick, greasy scales and flakes on your baby’s scalp most of the time and sometimes on the eyebrows as well. It can cause redness that may appear as red or pink in babies with lighter skin tones and brownish in babies with darker skin tones behind the ears, in the skin folds, and in the diaper area.

Even though researchers do not know the exact cause of this condition, it is believed to be caused by a combination of factors such as hormonal changes in the baby’s body, overactive sebaceous glands, and overproduction of Malassezia yeast on the skin.

Can You Pick at Cradle Cap?

Let me give an example as we prepare to answer, “Should you pick at cradle cap”. Many who are pondering what to do with the scale on their infant’s scalp may have dealt with acne as an adolescent and perhaps are even now battling with this affliction. 

The advice given for the management of acne is to leave it alone. Picking at acne lesions can lead to changes in the coloration of the skin and scarring that are worse than if you just left it alone.  

Just like this, it is essential that you do not pick at cradle cap. It will also make the condition worse. 

But what happens if you pick at cradle cap? If the scales are dry and stubborn, never forcefully try to remove them by picking. Your fingernails can damage the skin beneath the scales and further exacerbate the condition by worsening the inflammation and irritation and also causing scaring. 

According to the American Academy of Dermatology, if you pick at cradle cap it can cause infection. The germs and bacteria from your fingernails can transfer to the baby’s skin and attack the damaged skin from picking, which will ultimately lead to skin infections. 

Picking Cradle Cap and Hair Loss

Does picking cradle cap cause baldness? The answer is no. Picking at scales, scratching, and inflammation can lead to temporary hair loss. But don’t worry; the hair will grow back to normal as soon as the irritation and scaling improve.

Many babies will lose their hair as the crusts and scale fall off—this is normal. Even without scale and crust, generalized hair loss is a normal process as children approach four months of life. On a side note, many parents have come to me with concerns about hair loss in occuring only on the back part of their scalp. This is the point of maximal contact with the sleeping surface, and hair loss occurring in just this area in an infant is also most likely completely normal.

Treating Seborrheic Dermatitis

medicated shampoo and brush

So now the question arises how do you remove cradle cap flakes and scales if you can’t pick at them? There are various options for removing scales, however the best thing for cradle cap scales is to use a medicated shampoo.

Cradle Cap Shampoo

If you start to see scales and crust on your baby’s eyebrows and scalp, I would suggest using whatever shampoo you currently are using, working up a nice lather, and massaging the product gently but thoroughly onto the affected areas.

However, a regular baby shampoo will only help you soften the scales and not target the root cause of cradle cap. So it is best to use a medicated cradle cap shampoo for your baby that contains pyrithione zinc as an active ingredient. 

Researchers believe that zinc pyrithione helps control the production of Malassezia yeast on the skin and in turn can help reduce flaking and scaling in conditions like seborrheic dermatitis and dandruff. 

  • Massage the cradle cap shampoo and body wash, focusing more on the affected areas
  • Leave it on for a few minutes before rinsing it off. 
  • Rinse thoroughly without leaving any residue behind.
  • Pat dry your baby’s skin and scalp instead of rubbing it. 

Pro tip #1! Soft spot technique:

The crusts of cradle cap like to hang out on the soft spot, technically called the anterior fontanelle. Many caretakers of infants have a fear of rubbing on this area. It is a delicate area but fear not. When you are massaging, you are NOT pushing down on the soft spot; you are just gently agitating the shampoo’s lather with your fingers to try to loosen the scales.

If you are wondering “How often can or should I wash my baby?” You can wash your baby daily without hesitation and use the cradle cap shampoo daily when the scaling is severe. Some babies really like baths, and some, as you may already know, do not enjoy being bathed. In that case you may need to settle on only using the shampoo 2 to 3 times a week despite the severity. 

Cradle Cap Brushes

Searching Amazon or going to the baby aisle will reveal a plethora of cradle cap brushes and scale removal products. Some people swear by them. You can add a cradle cap brush to the above technique instead of massaging with your fingers to get rid of the scales more easily. 

Here is how to remove cradle cap flakes with a brush or comb.

  • Use the cradle cap comb or brush to massage your baby’s scalp in soft circular motions while shampooing.
  • This will help soften the scales and remove the loose ones easily.
  • If the scales are not coming off, then don’t brush over them again and again. Just be patient. They will come off soon.
  • You can also use it for dry brushing. It may help promote blood flow in the baby’s scalp and relaxation. 

Cradle Cap Home Remedies

You will read across the internet and hear from friends and family to try any number of oils or petroleum jelly. You can try olive, coconut, almond, or mineral oil—some kids improve with these things. 

However, sometimes these greasy products may make the situation worse. The oils may give the yeasts naturally occuring on the scalp more substrate to cause further irritation.  Some folks will advocate trying breast milk for cradle cap; this will not hurt and could possibly help in the long run.

What Do Pediatricians Recommend?

About 20-30% of pediatricians suggest doing nothing or trying one of the above oil-based products to loosen the scale. Some families are fine with doing nothing, but many moms and dads get tired of looking at and smelling the aesthetically displeasing cradle cap.  

The other 70% of providers will suggest anti-dandruff shampoo, which targets the root of the problem, Malassezia. Most pediatricians suggest a pyrithione zinc, or selenium sulfide-based product. 

The problem when an adult anti-dandruff product is suggested is that they are laden with potential skin irritants like scent and color, which can further dry out the baby’s sensitive skin. We would recommend a product that avoids the use of harmful ingredients such as fragrances, dyes, parabens, and sulfates.

Luckily many pediatricians and pediatric nurse practitioners are now aware that there exists baby safe anti-dandruff shampoos. Happy Cappy Medicated Shampoo and Body Wash is an example of a safe medicated baby shampoo for cradle cap that is free from harsh chemicals, and can be used on the skin for children of all ages. It is noteworthy that Happy Cappy’s Medicated shampoo has received praise as the “best seborrheic dermatitis shampoo for babies” by VeryWell health magazine.

Key Takeaways

  • Never pick at your baby’s cradle cap.
  • Picking at scales can lead to skin damage, irritation, scarring, and even skin infections.
  • Either leave the flakes alone or use baby shampoo for cradle cap to remove the scales. 
  •  Use a seborrheic dermatitis shampoo that contains pyrithione zinc as an active ingredient to target the root cause.
  • You can also use a cradle cap brush while shampooing to remove the scales. 

FAQs

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Dr. Eddie Valenzuela is an award winning pediatrician and the founder and CEO of Pediatric Solutions, LLC.

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Is it ok to pick at cradle cap?

No, it is not ok to pick at scales. Picking can damage your baby’s sensitive skin, cause temporary hair loss, and even lead to serious skin infections.

Should you remove cradle cap or leave it alone?

You can leave your baby’s cradle cap alone if you want to. However, if you want to remove cradle cap then the best thing you can do is use a cradle cap shampoo to clean your baby’s scalp and hair. If the cradle cap is severe use daily for a week before tapering to a minimum of twice per week. If cradle cap is mild, then start with use of the cradle cap shampoo two to three times a week.

Does it hurt to scratch off cradle cap?

Yes, scratching off scale and flakes can hurt your baby. Babies have very delicate skin that can be easily affected by scratching, vigorous rubbing, and picking. Also, if you pick at scales, you might accidentally pull their hair, which will hurt them.

Does picking cradle cap make it worse?

Yes, picking cradle cap will only make it worse. You can cause damage to your baby’s skin and may trigger other serious complications like infections to develop.

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