Also indexed as: Cradle Cap, Infantile 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.
Checklist for Seborrheic
Dermatitis
What are the symptoms of seborrheic dermatitis?
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 treatments
Over the counter products commonly used to treat dandruff often contain selenium sulfide
(Selsun Blue®, Head & Shoulders®), salicylic acid (Ionil Plus®, P &
S®), or coal tar (Ionil T®).
Prescription drug treatment includes the use of selenium (Selsun®) and topical cortisone-like drugs, such as betamethasone
(Diprosone® Lotion) 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.
Nutritional supplements 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 vera (Aloe
barbadensis) 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.
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purposes only. It is based on scientific studies (human, animal, or in vitro),
clinical experience, or traditional usage as cited in each article. The results reported may
not necessarily occur in all individuals. For many of the conditions discussed, treatment with
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before making any changes in prescribed medications. Information expires March 2005.
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