What causes a red, flaky scalp in babies?

Question

Hello doctor,

I have a two-month-old baby. Since birth, the back of her head has been red. Recently, I noticed a red spot with white flakes on it. It may be causing itching or irritation because she keeps trying to scratch it with her hand.

What should I do?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Thanks for providing the picture (attachments are removed to hide the patient’s identity), in addition to your question. I am a pediatrician, and I understand your concerns.

From your description, it seems that the rash in the back part of your baby’s scalp is reddened, and it has tiny flakes, white or yellowish in color, which is compatible with seborrheic dermatitis (cradle cap). It is quite a common and harmless disease in babies. In some cases, the surrounding area gets inflamed, and it becomes itchy.

There are no clear signs of a severe infection, including abscess formation, inflammation, and ulcers.

At the moment, I suggest the following course of treatment:

Washing the scalp with a mild shampoo two to three times per week.
Prior to bathing, you can rub some mineral oil, baby oil, or coconut oil on the rash and keep it for 15 to 20 minutes.
Do not forcefully remove the flakes.
Keep your baby's nails trimmed or use infant mittens if she is scratching the area.
Avoid applying home remedies or medicated creams unless prescribed.

Please have your baby examined by a pediatrician if you notice:

A few yellowings, discharges, pustules, and smells can exist.
Symptoms include swelling, heat, and pain.
A fever or bad eating habits have been experienced.
Rash has extended to bigger areas of the body or has not shown improvement within a week or two.

Questions to help guide you further:

Is the rash present only on the scalp, or is it also on the face, behind the ears, or in the neck folds?
Is your baby exclusively breastfed or formula-fed?
Is she otherwise feeding well and gaining weight?
Was she born with this redness, or has this come about just recently because of the presence of the white scales?

According to the picture and the patient's history, the condition appears to be cradle cap with mild scalp inflammation, but if the symptoms worsen, an examination should be done.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.