Treatment

Treatment:

• none - if mild; the rash clears spontaneously over 2-3 months
• cradle cap - scaling may be removed by massaging arachis oil, baby oil, olive oil or 2% salicylic acid in aqueous cream into the scalp prior to using a mild shampoo
• if the simple measures don't work, a ketoconazole 2% cream once a day can be prescribed. Continue application till a few days after the affected area has healed. Ketoconazole 2% shampoo is another option, applied twice a week, for 2-4 weeks until symptoms clear
• topical corticosteroids are usually not recommended, although they may be useful in some infants with nappy rash. For severe cradle cap or a more generalised dermatitis, apply a mild topical steroid such as 1% hydrocortisone, 1-2 times daily. Combine with nystatin or miconazole in the nappy area for suspected candidiasis. Generalised dermatitis should also be treated with regular use of emollients.

Reference

1. Victoire A, Magin P, Coughlan J, et al. Interventions for infantile seborrhoeic dermatitis (including cradle cap). Cochrane Database Syst Rev. 2019 Mar 4;3:CD011380.