# Infantile Seborrhoeic Dermatitis (Cradle Cap) - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: Egyptian National Drug Formulary - Antimicrobial 2023 (miconazole monograph) · Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) · DermNet: Cradle cap (infantile seborrhoeic dermatitis) - Verified date: 2026-08 ## Verified against - DermNet: Cradle cap (infantile seborrhoeic dermatitis) - Egyptian National Drug Formulary - Antimicrobial 2023 (miconazole monograph) - Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) ## Treatment metadata - Liquid paraffin — topical - Miconazole — topical - Hydrocortisone — topical ## Complete treatment card ```text INFANTILE SEBORRHOEIC DERMATITIS (CRADLE CAP) Sources: Egyptian National Drug Formulary - Antimicrobial 2023 (miconazole monograph) · Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) · DermNet: Cradle cap (infantile seborrhoeic dermatitis) Review status: REVIEWED against 3 sources listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (4) - The rash usually isn't itchy or painful and the baby seems content, even though it can distress parents to see [itching · rash] - It typically begins in the second week of life and lasts around 4 to 6 months - The condition is generally mild and resolves on its own - It starts in the first 3 months of life, stays mild, and settles on its own - in most babies by the end of the first year SIGNS - what you find (3) - It affects the same facial areas as the adult form, plus the diaper region, neck folds and armpits - Cradle cap is an adherent yellowish scale-crust over the crown and front of the scalp that can spread to the whole scalp - Thick silver or yellow scale binding the hair into tufts can occur but isn't specific to seborrhoeic dermatitis TESTS (1) - Investigation isn't routinely needed for seborrhoeic dermatitis; it is a clinical diagnosis IF NOT THIS - what else fits (8) - Unlike seborrhoeic dermatitis, atopic dermatitis is itchy and weeping, affects the face and limb creases while sparing the trunk, and leaves scratch marks on an upset infant - Tinea capitis shows broken hairs or black dots, distinguishing it from cradle cap and being rare in adults - Impetigo leaves a honey-coloured crust rather than the greasy scale seen in cradle cap - Irritant contact dermatitis in the nappy area tends to spare the skin folds, unlike seborrhoeic dermatitis - Candidal nappy rash shows satellite lesions and can arise from colonisation by fecal yeast - Infantile psoriasis shows sharply defined red plaques with a silvery scale, distinct from ISD's greasy scale - Langerhans cell histiocytosis (histiocytosis X) tends to stay in the skin creases, with a purple-red rash cropping up elsewhere on the body - Acrodermatitis enteropathica involves the skin around body orifices and warrants checking zinc levels Source StatPearls "Seborrheic Dermatitis" - disease-level clinical article Status traced to the source above 1. LIQUID PARAFFIN [1st line] Adult Massage baby oil, olive oil, or emollient onto the scalp scales, leave to soften, then gently brush with a soft brush and wash off with baby shampoo - daily until scales clear; repeat as needed Peds Infants only; avoid getting oil or emollient in the eyes Source DermNet: Cradle cap (infantile seborrhoeic dermatitis) Why First-line and usually sufficient on its own; most cases resolve with scale-softening and washing alone, without any medicated product Caution Do not pick or scratch off scales - this can cause secondary infection. Reassure caregivers this is self-limiting and usually clears within weeks to a few months. Seek review if the rash spreads beyond the scalp or looks infected. Egypt ADCOCARE CREAM 20 GM ARAB DRUG COM... 12.00 EGP -> ! also contains glyceryl monostearate, propylene glycol, urea DERMOLAN CREAM 50 GM HI-CARE > EMI... 19.00 EGP -> ! also contains allantoin, glycerol, glycolic acid, panthenol, salicylic acid, urea, vitamin c, zinc oxide ADCOCARE CREAM 40 GM ARAB DRUG COM... 21.75 EGP -> ! also contains glyceryl monostearate, propylene glycol, urea CARE MIX PLUS HAIR CREAM 50 GM VITA PHARM > ... 29.50 EGP -> ! also contains cetostearyl alcohol, lanolin, panthenol, wheat protein, white soft paraffin PROPOLIS CREAM 15 ML LUNA FOR PERF... 30.00 EGP -> ! also contains cera alba, glycerin, propolis PROPOLIS CREAM 30 ML LUNA FOR PERF... 55.00 EGP -> ! also contains cera alba, glycerin, propolis HEALTHPOINT NAPPY CREAM 100 GM HEALTHPOINT L... 70.00 EGP -> ! also contains benzyl alcohol, cetearyl alcohol, glyceryl stearate, lanolin, peg-100 s, water, zinc oxide HERCUL WHITENING CREAM 60 GM LEADER FOR CO... 74.75 EGP -> ! also contains alpha arbutin, diemthicone, glycerin, licorice ext, octyl methoxy, titanium dioxide, vit.c 2. MICONAZOLE [2nd line] Adult Apply 2% cream once or twice daily to affected areas x up to 4 weeks; seek specialist advice if not resolved by 4 weeks Peds Ketoconazole is deliberately not used here - the adult scalp and face seborrhoeic dermatitis entry restricts ketoconazole to children over 12 years. Note the Egyptian formulary's paediatric section for topical miconazole starts at 2 years, so use below that age is outside the labelled age range. Source Egyptian National Drug Formulary - Antimicrobial 2023 (miconazole monograph) Why Second-line when scale or inflammation persists despite emollient measures, or when the rash extends beyond the scalp (e.g. flexures, napkin area) Caution Avoid contact with the eyes. Stop and seek review if irritation worsens. Reassess if no improvement after 4 weeks of treatment. Egypt MICONOL 2% CREAM 15 GM MEMPHIS 5.00 EGP DERMOZOL 2% GEL 15 GM PHARCO 6.00 EGP MICOBAN 2% CREAM 20 GM AMRIYA 9.00 EGP MICONAZ 2% CREAM 20 GM MUP 15.00 EGP MICONAZ 2% ORAL GEL 20 GM MUP 23.00 EGP DAKTARIN 2% CREAM 15 GM MINA PHARM > ... 28.00 EGP DAKTARIN 2% ORAL GEL 40 GM JANSSEN CILAG... 53.50 EGP ADCOZOLE 2% TOPICAL CR. 15 GM ARAB DRUG COM... 7.25 EGP 3. HYDROCORTISONE [3rd line] Adult Apply 1% cream thinly once daily to visibly inflamed areas only - short course only, up to 1 week, then stop Peds Rarely needed; most infantile seborrhoeic dermatitis resolves without steroids. Use the lowest effective potency for the shortest time Source Hydrocortisone 1% cream SmPC section 4.2 (eMC product 13103) Why Reserved for the minority of cases with marked inflammation not settling with emollient and antifungal measures. This is a rare, third-line, medically-supervised step - unlike the adult scalp/face entry, where topical steroids are a routine option Caution Reserve for inflamed cases not responding to emollients or antifungal cream - not a first-line treatment in infants. Use only a thin layer for a short course; infant skin absorbs topical steroid more readily than adult skin. Stop as soon as inflammation settles. Limit a course in a child to 7-10 days. The scalp absorbs far more corticosteroid than limb skin - this matters most in an infant. Egypt NOVACORTIN 1% CREAM 15 GM PHAROPHARMA 4.75 EGP NOVACORTIN 1% OINT. 15 GM PHAROPHARMA 4.75 EGP MICORT 1% CREAM 20 GM MISR 12.50 EGP HYDROCORTISONE 1% OINT. 20 GM MISR 21.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)