Infantile seborrhoeic Dermatitis

Infantile seborrhoeic dermatitis (which may also be known as ISD, cradle cap or milk crust) is a skin condition that occurs in babies, usually before they are 6 months old.

The condition is related to the overproduction of a yeast known as malassezia, which is naturally found on the skin, but in certain babies, develops excessively.

Infantile seborrhoeic dermatitis tends to present in areas of the body where there are a lot of sebaceous (oil-producing) glands, such as the scalp, nose and back, but in babies, it may also occur in the nappy area or in the folds of the skin.

While infantile seborrhoeic dermatitis may look very red and scaly, and can cause the developing hair to fall out, parents can be reassured that the condition doesn’t usually bother the baby. In the vast majority of cases, infantile seborrhoeic dermatitis usually resolves before the baby’s first birthday, on average at about 6 months old.

In some cases, infantile seborrhoeic dermatitis can develop into atopic eczema, and this may need further treatment; a GP will be able to diagnose and treat this.

Treatment for infantile seborrhoeic dermatitis are available over the counter from the chemist, but if parents stop using them when they see results, the condition may recur. It’s typical to see the patches change colour and appear to match the surrounding skin after treatment, but when treatment is discontinued, the skin will once again become discoloured as patches redevelop over the course of several weeks.

In older children and adults, seborrhoeic dermatitis on the scalp is usually just called dandruff, and in contrast to other forms of eczema, seborrhoeic dermatitis is not an allergy.

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Infantile Seborrhoeic Dermatitis

Treatment for infantile seborrhoeic dermatitis are available over the counter from the chemist, but if parents stop using them when they see results, the condition may recur.

It’s typical to see the patches change colour and appear to match the surrounding skin after treatment, but when treatment is discontinued, the skin will once again become discoloured as patches redevelop over the course of several weeks.

Symptoms of Infantile Seborrhoeic Dermatitis

The symptoms of infantile seborrhoeic dermatitis are:

Discolouration and a different texture compared to the rest of the baby’s skin, for example, a yellow crust;
Red skin that has white or yellow flaky scales or lesions;
Areas of the skin that are blotchy and pink, and join up with the red skin;
Areas of the skin that are swollen.

It should be reassuring to parents that the majority of babies are not bothered by the symptoms of infantile seborrhoeic dermatitis.

There are 3 different areas that can present with symptoms of infantile seborrhoeic dermatitis, and they are:

On the Scalp

Rough, scaly patches of skin develop, and they may be thick, greasy and sticky. The patches can be discoloured, usually white or yellow, and they may appear as smaller areas, or cover the entire scalp. Hair will grow through the scaly lesions, but as they fall off, the hair will fall out too. In some cases, infantile seborrhoeic dermatitis can also affect the hair of the eyebrows.

In the Diaper Area

Infantile seborrhoeic dermatitis in this area presents as a rash that can be bright red. The rash might only appear in the folds of the skin, but it can cover the entire area that a nappy would cover, or extend beyond the skin that would be covered. When infantile seborrhoeic dermatitis presents in this area, it is typical for the condition to affect the scalp as well.

In the Folds of the Skin

Infantile seborrhoeic dermatitis in this area presents as a rash that can be bright red, and may occur in the inner arm, around the elbows, or behind the knees. When infantile seborrhoeic dermatitis presents this way, the condition is likely to also affect the scalp.

In more severe cases of infantile seborrhoeic dermatitis, parents should monitor the baby’s skin for signs of infection, for example:

Areas of the skin that feel hot to the touch;
Areas of the skin that weep fluid;
A noticeable change in odour of the skin.

If your baby does have an infection, visit the GP so that treatment can be prescribed.

Causes of Infantile Seborrhoeic Dermatitis

The exact cause of infantile seborrhoeic dermatitis is unknown, but it is linked to the sebaceous glands and believed to be a combination of factors.

These factors include:

The overproduction of a naturally-occurring yeast that lives on the skin;
Genetic factors, such as a family history of seborrhoeic dermatitis;
Stress;
Exposure to certain chemicals that are irritants;
Dry or cold weather conditions that cause the skin to overproduce oil;
Residual hormones associated with pregnancy that are present in the mother.

Treatment of Infantile Seborrhoeic Dermatitis at Derma

While the pharmacist or your GP can be very helpful in diagnosing and treating cases of infantile seborrhoeic dermatitis, we are more than happy to see patients who prefer to consult a private dermatology specialist.

The appointment will begin with an examination of the infant’s skin (also called a skin check) and the parents’ medical histories, which will allow the dermatologist to rule out any underlying or co-occurring condition.

Together with the dermatologist, you will be able to discuss the latest and most effective treatments and explain all potential side-effects, enabling you to select the best option for your child.

Most cases of infantile seborrhoeic dermatitis can be managed using topical treatments available from chemists, but prescription creams may be helpful in more severe cases.

Whatever your baby’s needs, you can rest assured that Derma will provide the very best care for their sensitive skin, with access to the latest research and treatment methods.

Further reading: Patient leaflet from the British Association of Dermatologists

Seborrhoeic dermatitis

Related Specialists at Derma

Dr Rima Clayton

Consultant Dermatologist

General dermatologyPaediatric dermatologySkin surgery

Founder of Derma Reading, seeing adults and children, with a particular interest in skin cancer and skin surgery.

Dr Inge Kreuser-Genis