Treatment
Treatment other than gentle washing is not necessary in most mild cases (flaking, with or without small patches of yellow crusting), as the problem often resolves itself whether the cause is sebaceous-gland-related or fungal, but since many patients (and/or parents) are concerned about cosmetic issues, the following options are often considered:
For all ages: Home remedies include the application of various oils, lotions, or petroleum jelly. There is little adequate or controlled research to support or negate the usefulness of most common home remedies at any age, but there is anecdotal evidence to support either position. When cradle cap is related to fungal infection, such as Tinea capitis, treatment for fungal infections can be effective. Doctors may prescribe a seven-day daily application of clotrimazole (commonly prescribed for jock itch or athlete's foot) or miconazole (commonly prescribed for vaginal yeast infections).
For infants: in cases that are related to fungal infection, doctors may recommend once-daily application of clotrimazole (1%) or miconazole (2%) for seven to fourteen days. Overnight use of mineral oil, or other emollient, followed by gentle brushing and brushing with baby shampoo is an option. Steroids are not recommended since topical use in children can achieve significant systemic levels.
For toddlers: doctors may recommend a treatment with a mild dandruff shampoo such as Selsun Blue or Neutrogena T-gel, even though the treatment may cause initial additional scalp irritation. A doctor may instead prescribe an antifungal soap such as ketoconazole (2%) shampoo, which can work in a single treatment and shows significantly less irritation than over-the-counter shampoos such as selenium disulfide shampoos, but no adequate and controlled study has been conducted for pediatric use as of 2010.
For adults: Seborrheic dermatitis (the adult version of cradle cap) usually requires the use of an antifungal shampoo, possibly along with the nightly application of an antifungal cream or an anti-itch cream/gel like Scalpicin. Some doctors also recommend the supplementation of a B-vitamin complex to improve fatty acid metabolism.
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