Seborrheic Dermatitis in Infants

Seborrheic dermatitis in infants is a common, benign, and non-contagious condition. We'll tell you everything you should know about it in the following article.

Written and verified by the dermatologist Maria del Carmen Hernandez.

Last update: 02 May, 2023

Seborrheic dermatitis in infants usually appears in the second week of life and may last from 4 to 6 months. Its peak incidence is around 3 months of age. In most cases, it’s mild and self-limiting.

What is seborrheic dermatitis in infants?

It’s also known as cradle cap or pityriasis capitis. In fact, the name cradle cap refers to its anatomical location. It presents as an adherent yellowish crust arising on the crown and front of the scalp. A serous exudate and a greasy crust may also be observed.

This type of condition occurs commonly in childhood and is characterized by mild cases that will require little or no treatment. The most important thing about this type of condition is to clarify that it’s not contagious, as this is an issue that generates great concern in parents.

Causes of seborrheic dermatitis in infants

Distinguishing the causes of these skin manifestations isn’t an easy task, however, there are some established causes:

• Increased activity of the sebaceous glands, due to the secondary influence of maternal circulating hormones
• Genetic factors
• Skin fungi that develop on the skin surface. Namely, the yeast Malassezia
• Alterations of the skin microbiota

Clinical manifestations of seborrheic dermatitis in infants

Skin manifestations are characterized by erythematous plaques with yellow, greasy-looking scales. The rash is usually not itchy or painful and infants appear happy, although parents may be distressed. In addition, it usually doesn’t disrupt the sufferer’s sleep or feeding.

It usually resolves spontaneously within a few weeks. Therefore, it has a good prognosis and, according to a review in The Practitioner, it doesn’t tend to remit.

Frequent locations

Its location is characteristic; it may occur in areas where there’s a higher concentration of sebaceous gland activity. Some of these regions of the body are the following:

• Scalp
• External ears
• T-line of the face
• Diaper region
• Skin folds of the neck and armpit

Diagnosis of seborrheic dermatitis in infants

The diagnosis of seborrheic dermatitis in infants is made at the doctor’s office by analyzing the appearance and locations of the skin scales. In turn, no biopsy or other diagnostic procedure is required to start the appropriate and effective treatment.

Differential diagnosis

In turn, a differential diagnosis with other diseases with similar clinical manifestations should be considered:

• Psoriasis: This disease causes a reddening of the skin and the presence of white scales that may look like dandruff. In addition, it can generate intense itching that causes scratching lesions.
• Atopic dermatitis: This is characterized by the presence of inflammation and itching in the folds of the elbows, popliteal hollow, and frontal region of the neck. It usually occurs in childhood and the condition diminishes with the passage of time.
• Pityriasis versicolor: Unlike seborrheic dermatitis, the spots of pityriasis versicolor aren’t usually colored. They occur on the trunk, back, and shoulders.
• Rosacea: Doesn’t cause a large amount of scaling and occurs only on the face.

Therapeutic options for infantile seborrheic dermatitis

In general, good skin care practices such as not using very hot water in the shower, using syndet soaps, and assuring adequate moisturization are generally used.

According to reviews by Cochrame, treatments for infantile seborrheic dermatitis are still unclear as to their effectiveness.

In cases where hygienic measures don’t help to improve the condition, a doctor should be consulted, who will prescribe a cream with corticosteroids or antifungal agents for other parts of the body.

The treatment of seborrheic dermatitis in infants

In most cases, this is a self-limiting condition that resolves spontaneously. However, there are different measures to accelerate the process:

• The baby’s scalp should be washed with a mild shampoo combined with an emollient (liquid petroleum jelly, almond oil, or baby oil) before shampooing.
• After rinsing, gently remove the scales that softened with the use of the oil.
• Those that don’t improve are usually managed with 2% ketoconazole or 1% hydrocortisone creams for one week.

What to remember about seborrheic dermatitis in infants

Infantile seborrheic dermatitis is a common, benign, non-contagious condition. At the same time, it’s a disease that resolves spontaneously.

Therefore, self-medication isn’t recommended because it could worsen the condition or cover up symptoms that reveal the existence of another disease.