As a new parent, trying to spot the difference between cradle cap vs. eczema can be tricky. Trust us, we know your frustration! Here’s what you need to know about the difference between these two very similar — but different — skin conditions.
Seborrheic dermatitis is a type of eczema, and when it affects infants on their scalp it’s called “cradle cap.” Medically referred to as Infantile Seborrheic Dermatitis (ISD), this skin condition appears on a newborn’s scalp as yellow, scaly patches surrounded by a red rash that doesn’t itch. Cradle cap typically clears up by the time the child is 12 months old and leaves no negative impact on their health.
Unlike cradle cap, atopic dermatitis, the most common form of eczema, is characteristically itchy and can appear anywhere on the body. Atopic dermatitis is a common, chronic skin condition that can recur throughout childhood and adulthood.
Here’s a breakdown of the differences between these conditions, what causes them, and how to find relief.
Appearance
Both cradle cap and atopic dermatitis can cause flakiness and dry skin; however, there are noticeable differences in how these two conditions present.
Appearance of Atopic Dermatitis
Atopic dermatitis, commonly referred to as eczema, presents as patches of dry, inflamed, and irritated skin. It can appear anywhere on the body, but the elbows, hands, feet, and the area behind the knees are most commonly affected. Eczema on a baby’s scalp can occur, though it will likely appear in other areas as well. Atopic dermatitis can look different on various skin tones. On dark skin tones, an eczema rash can look purple, brown, or gray. The rash can look pink, red, or purple on light skin tones. The skin will appear raw and sensitive, or thick and hardened.
It’s possible to confuse atopic dermatitis for drool rash or even baby acne in infants since they share similarities in appearance. Even though drool rash can be itchy, it is typically localized to the baby’s mouth and chin, while atopic dermatitis could appear anywhere on the skin. Atopic dermatitis can be bumpy like baby acne, but baby acne does not itch or flake.
Appearance of Cradle Cap
Cradle cap usually looks like a yellow or brown scaly layer on a baby’s scalp. Resembling fish scales, the skin may feel fragile, flaky, oily, or waxy to the touch. The skin underneath this scaly layer usually looks normal. Cradle cap may also present as:
- Mild, patchy scales
- Red skin surrounded by pink patches
- Thick, oily yellow scales
- Crusty brown scales
Causes
The exact causes of atopic dermatitis and cradle cap remain unknown, but experts have discovered several contributing factors that seem to trigger these conditions.
Causes of Atopic Dermatitis / Eczema
Experts believe that eczema is caused by genetic factors, environmental factors, and bacterial factors. The genetic factors include:
- Filaggrin (FLG) deficiency: An insufficient production of the FLG protein affects the skin barrier. This leaves the skin more prone to allergy, eczema, and infection.
- The immune system: Some genetic mutations cause immune system dysfunctions, which can lead the body to overreact to irritants. The immune system’s defense is to create inflammation, and inflammation can lead to eczema symptoms.
- Family History: Your child is more likely to have eczema if there is a history of eczema or dermatitis in your family. A history of asthma, allergies, or hay fever also puts them at higher risk.
Aside from genetics, the bacteria that live in the skin microbiome may contribute to eczema. An overgrowth of pathogenic bacteria can on the skin can trigger the immune system to overreact, leading to eczema symptoms.
There are also environmental triggers that can lead to eczema flare-ups, including:
Causes of Cradle Cap
Overactive oil-producing sebaceous glands may play a role in causing cradle cap. Scientists believe that the changing hormone levels in the mother’s body during pregnancy could cause a baby’s sebaceous glands to overproduce oil. When there is an abundance of oil, skin cells get stuck and are unable to shed normally, leading to scaly buildup.
Natural yeasts may also be a contributing factor. Studies have found a link between cradle cap and Malassezia, a yeast that causes high fatty acid secretion. It’s still uncertain whether these yeasts cause cradle cap, or simply take advantage of the overproduction of sebum that’s already happening.
Cradle cap is not caused by bacteria, allergies, lack of hygiene, or lack of care. It’s not contagious and cannot be transferred from person to person.
Symptoms
Cradle cap and atopic dermatitis have a lot of overlapping symptoms, which is why it’s important to pay attention to key differences.
Symptoms of Atopic Dermatitis
Symptoms of atopic dermatitis include:
- Dry skin
- Itchy skin
- Skin rash
- Bumps on the skin
- Thick, leathery patches of skin
- Flaky, scaly or crusty skin
- Swelling
Symptoms of atopic dermatitis can appear anywhere on your body. The most common places you may notice symptoms include your:
- Hands
- Face, especially cheeks
- Neck
- In and around ears
- Lips
- Ankles
- Elbows
- Knees
- Feet
You may also notice redness, swelling, cracking, scaling, and weeping clear fluid from scratching or picking at the affected skin. In most cases, eczema goes through periods of worsening called flares, and periods where the skin improves, called remissions.
Symptoms of Cradle Cap
Symptoms of cradle cap include:
- Crusty or oily scales on the scalp that appear brown or yellow
- Scales that feel fragile, waxy, or greasy
- A red rash surrounded by pink patches
- Symptoms appear within the first few weeks of life and typically disappear by 12 months of age
Cradle cap is specific to the scalp area and is rarely itchy, but other skin conditions affecting infants do itch. If your baby’s rash is appearing on other areas of the body and causing discomfort, check for symptoms of diaper rash, atopic dermatitis, and ringworm.
It’s important to know that cradle cap is not caused by allergies, bacteria, or infection. If your baby’s rash feels warm, smells bad, or weeps fluid, an infection may have occurred. In this case, seek medical help for immediate treatment.
Diagnosis
Your baby’s healthcare provider will most likely do a simple assessment to determine the diagnosis. This may include:
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Reviewing your little one’s health history, to see if they have a family history of eczema or other skin problems. They may also ask about current prescriptions and previous health conditions.
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A physical observation, to assess the affected skin and consider the symptoms.
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Additional tests, only if your child’s healthcare provider suspects the symptoms are a result of another condition.
Treatment
Once you know what condition you’re dealing with, you can consider treatment options.
Managing Atopic Dermatitis
Each case of eczema is unique and requires personalized care. Symptoms and severity can vary person to person, so it’s important to find a treatment plan that suits your little one’s skin. You can help your little one find relief by:
- Giving your baby regular eczema baths in lukewarm, not hot, water
- Moisturizing immediately after a bath to prevent dry skin
- Avoiding known eczema triggers
Eczema flare-ups can be complicated and frustrating for you and your child. We created a Parent Guide to Eczema to help you navigate this condition and provide your child with the best treatment plan possible.
Managing Cradle Cap
Mild cases of cradle cap often resolve on their own within a couple of weeks or months. That said, there are several home remedies that have shown to reduce symptoms:
- Wash your baby’s scalp daily with mild baby shampoo.
- Gently brush or massage your baby’s scalp with a soft toothbrush, to loosen scales and improve blood flow.
- Apply mineral oil to your baby’s scalp and wrap it in a warm, wet towel for about an hour before bathing.
- Apply an over-the-counter cradle cap lotion about 15 minutes before using shampoo. Rinse well before shampooing.
Treatments for cradle cap are usually home remedies or over-the-counter products, so be sure to talk to your healthcare provider before introducing any new products. Do your research when choosing baby skincare products to ensure you’re not introducing any harmful irritants to the skin. Talk to your doctor if any symptoms worsen. Most cases of cradle cap resolve on their own within six to 12 months.
Eliminate the Confusion Between Cradle Cap vs. Eczema
As a parent, you have a lot on your mind! When in doubt, if you’re struggling to determine whether your little one is experiencing atopic dermatitis or cradle cap, talk with your child’s pediatrician or a pediatric dermatologist. Receiving a proper diagnosis helps ensure your baby gets the fastest and most effective treatment.Soothe Your Baby's Skin With Gladskin
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