Also indexed as: Cradle Cap, Infantile Seborrheic
Dermatitis
A dry, flaky scalp on a baby is often called cradle cap. But
adults also suffer from this skin condition. According to research or other evidence, the
following self-care steps may be helpful:
- Smooth on aloe
- To improve scaling and itching, apply a topical herbal cream
containing 30% aloe emulsion from the Aloe vera plant
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full seborrheic dermatitis
article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and
dietary and lifestyle changes that may be helpful.
About seborrheic dermatitis
Seborrheic dermatitis is a common inflammatory condition of the skin. Cradle cap is a type
of seborrheic dermatitis found in infants; it is usually self-limiting and subsides by the age
of six months.
A qualified physician should diagnose these conditions. It is not clear whether research on
cradle cap is applicable to the type of seborrheic dermatitis that occurs in adults.
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seborrheic dermatitis
What are the symptoms?
A dry, flaky scalp is typical of mild cases of seborrheic dermatitis. More severe cases
have itching, burning, greasy scales overlying red patches on the scalp. Seborrheic dermatitis
may be confused with severe dandruff. However, seborrheic dermatitis may also be found on the
eyebrows, eyelids, forehead, ears, chest, armpits, groin, and the skin folds beneath the
breasts or between the buttocks.
Medical options
Over-the-counter products commonly used to treat dandruff often contain selenium sulfide
(Selsun Blue®, Head & Shoulders®), salicylic acid (Ionil Plus®, P &
S®, Scalpicin®), or coal tar/salicylic acid (Ionil T®, X-Seb T®).
Prescription drug treatment includes the use of topical selenium (Selsun®) and topical
cortisone-like drugs, such as betamethasone
(Diprosone® Lotion, Luxiq®), clobetasol (Olux®), and fluocinonide (Lidex®
Solution) to control symptoms.
Dietary changes that may be helpful
An early study reported that nursing infants with cradle cap improved when high-biotin foods, such as liver and
egg yolk, were added to the mother’s diet.1
A preliminary report suggested that an allergy
elimination diet for an infant may be useful in the treatment of cradle cap. The most
common offending foods identified were milk,
wheat, and eggs.2 More research is
needed to confirm the value of this approach in the treatment of cradle cap.
Vitamins that may be helpful
A group of researchers found that infants with cradle cap appeared to have an imbalance of
essential fatty acids in their blood that returned to normal when their skin rashes eventually
went away.3 In a preliminary trial, these researchers later found that application
of 0.5 ml of borage oil twice daily to the
affected skin resulted in clinical improvement of cradle cap within two weeks.4
Preliminary studies have found that injecting either the infant or the nursing mother with
biotin may be an effective treatment for
cradle cap.5 6 Studies of oral biotin have yielded mixed results in
infants. Older preliminary studies and case reports suggest that 4 mg per day of oral biotin
might be sufficient for mild cases of cradle cap, but 10 mg per day was required for more
severe cases.7 Two more recent, controlled trials found that oral biotin (4 or 5 mg
per day) produced no benefit.8 9 Thus, the scientific support for using
oral biotin to treat cradle cap is weak. The role of biotin in adult seborrheic dermatitis has
not been studied.
One physician reported that injections of
B-complex vitamins were useful in the treatment of seborrheic dermatitis in
infants.10 A preliminary trial found that 10 mg per day of folic acid was helpful in 17 of 20 cases of adult
seborrheic dermatitis.11 However, this study also found that oral folic acid did
not benefit infants with cradle cap. A preliminary study found that topical application of vitamin B6 ointment (containing 10 mg B6 per gram
of ointment) to affected areas improved adult seborrheic dermatitis.12 However,
oral vitamin B6 (up to 300 mg per day) was ineffective. Injections of vitamin B12 were reported to improve in 86% of adults
with seborrheic dermatitis in a preliminary trial.13 Oral administration of vitamin
B12 for seborrheic dermatitis has not been studied.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
A crude extract of aloe (Aloe
barbadensis, Aloe vera) may help seborrheic dermatitis when applied topically. In a
double-blind trial, people with seborrheic dermatitis applied either a 30% crude aloe emulsion
or a similar placebo cream twice a day for four to six weeks.14 Significantly more
people responded to topical aloe vera than to placebo: 62% of those using the aloe vera
reported improvements in scaling and itching, compared to only 25% in the placebo group.
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
References:1. Gyorgy P. Dietary treatment of scaly desquamative dermatoses of the
seborrheic type. Arch Derm Syph 1941;43:230–47.
2. Eppig JJ. Seborrhea capitis in infants: a clinical experience in
allergy therapy. Ann Allergy 1971;29:323–4.
3. Tollesson A, Frithz A, Berg A, Karlman G. Essential fatty acids in
infantile seborrheic dermatitis. J Am Acad Dermatol 1993;28:957–61.
4. Tollesson A, Frithz A. Borage oil, an effective new treatment for
infantile seborrheic dermatitis. Br J Dermatol 1993;129:95 [letter].
5. Nisenson A. Seborrheic dermatitis of infants: treatment with biotin
injections for the nursing mother. Pediatrics 1969;44:1014–6.
6. Messaritakis J, Kattamis C, Karabula C, Matsaniotis N. Generalized
seborrheic dermatitis: clinical and therapeutic data of 25 patients. Arch Dis Child
1975;50:871–4.
7. Nisenson A. Seborrheic dermatits of infants and Leiner’s
disease: a biotin deficiency. J Pediatr 1957;51:537–48.
8. Keipert JA. Oral use of biotin in seborrheic dermatitis of infancy: a
controlled trial. Med J Aust 1976;1:584–5.
9. Erlichman M, Goldstein R, Levi E, et al. Infantile flexural seborrheic
dermatitis. Neither biotin nor essential fatty acid deficiency. Arch Dis Child
1981;56:560–2.
10. Nisenson A. Treatment of seborrheic dermatitis with biotin and
vitamin B complex. J Pediatr 1972;81:630–1 [letter].
11. Callaghan TJ. The effect of folic acid on seborrheic dermatitis.
Cutis 1967;3:583–8.
12. Schreiner AW, Rockwell E, Vilter RW. A local defect in the metabolism
of pyridoxine in the skin of persons with seborrheic dermatitis of the “sicca”
type. J Invest Derm 1952;19:95–6.
13. Andrews GC, Post CF, Domnkos AN. Seborrheic dermatitis: supplemental
treatment with vitamin B12. NY State Med J 1950;50:1921–5.
14. Vardy DA, Cohen AD, Tchetov T, et al. A double-blind,
placebo-controlled trial of an Aloe vera (A. barbadensis) emulsion in
the treatment of seborrheic dermatitis. J Dermatol Treat 1999;10:7–11.