Cradle Cap in Adults: The Real Story
Cradle cap in infants, medically known as infantile seborrheic dermatitis, is a common skin condition. It presents as yellowish, greasy scales on a baby’s scalp. While the term “cradle cap” specifically refers to this infant form, adults can experience a very similar condition.
The adult counterpart to cradle cap is seborrheic dermatitis, a common, chronic inflammatory skin condition. Infantile cradle cap is considered a mild manifestation of seborrheic dermatitis. This condition affects areas of the skin rich in sebaceous (oil-producing) glands, such as the scalp, face, and chest. Unlike its infant form, adult seborrheic dermatitis tends to be a relapsing condition, meaning it can come and go.
Recognizing Adult Cradle Cap
Adult seborrheic dermatitis manifests with distinct signs and symptoms, particularly on the scalp. It commonly involves patches of greasy skin covered with flaky white or yellowish scales or crusts. This flaking can range from mild dandruff to thick, adherent crusts.
Affected areas include the scalp, eyebrows, sides of the nose, and behind the ears, due to the high concentration of oil glands. The skin underneath these scales may appear red and inflamed in lighter skin tones, while in darker skin tones, it might look pinkish, purplish, or show lighter or darker discoloration. Individuals often experience itching or a burning sensation, and severity can vary daily.
Why Adults Develop This Condition
The exact cause of seborrheic dermatitis is not fully understood, but it involves a combination of factors. A primary factor is an inflammatory reaction to an overgrowth of Malassezia yeast, a fungus that naturally lives on skin. An excessive amount of this yeast, combined with an individual’s immune response, can trigger the condition.
Several factors can contribute to or trigger flare-ups. Hormonal changes can stimulate oil glands and promote yeast proliferation. Stress and fatigue are also known to exacerbate symptoms. Certain medical conditions, including Parkinson’s disease and HIV infection, as well as some medications like lithium, can increase susceptibility. Cold, dry weather can worsen symptoms by drying the skin.
Effective Strategies for Management
Managing adult seborrheic dermatitis involves home care and, for persistent cases, medical intervention. For home treatment, medicated shampoos are a common approach, with active ingredients such as selenium sulfide, zinc pyrithione, salicylic acid, coal tar, or ketoconazole. These shampoos should be used regularly; gently massage the scalp to loosen scales before rinsing.
Gentle skin care is important, including washing affected areas with mild, fragrance-free cleansers and applying moisturizers to hydrate skin. Avoiding harsh detergents, strong soaps, and alcohol-based products can prevent irritation and flare-ups. For severe cases, a dermatologist may prescribe topical antifungal creams or shampoos, topical corticosteroids to reduce inflammation, or calcineurin inhibitors. Oral antifungal medications may be considered for extensive conditions. Long-term management is often necessary due to its chronic nature.