Q)My 18-month-old son has had cradle cap for nearly a year. I've tried frequent shampooing and applying olive oil, but there's no improvement. I'm keen to avoid any sort of drug treatment, so can you recommend some effective natural remedies?-K.T., Newcastle
A) Cradle cap is a form of seborrhoeic dermatitis- an inflammatory disease of the scalp, face and other areas of the body-commonly seen in infants. It's unsightly-with greasy, yellow, scaly patches on the scalp-but usually resolves within a few months even without treatment. However, it can persist.
Daily shampooing and massaging olive or mineral oil into the scalp at night, followed by gentle brushing and shampooing in the morning, is recommended. However, the follow-ing alternatives may also work.
- Borage oil. Infants with cradle cap had an imbalance of essential fatty acids in their blood that was normalized when their rashes cleared (J Am Acad Dermatol, 1993; 28: 957-61). The topical application of borage oil, rich in gamma-linolenic acid, can be effective for cradle cap (J Eur Acad Dermatol Venereol, 2004; 18: 13-26).
- Honey. As the fat-loving yeast Malassezia may play a role in cradle cap/seborrhoeic dermati-tis (J Eur Acad Dermatol Venereol, 2004; 18: 13-26), antifungals may help. Honey has proven antifungal activity against Malassezia (Am J Clin Dermatol, 2004; 5: 417-22) as a topical treatment (90-per-cent honey diluted in warm water) (Eur J Med Res, 2001; 6: 306-8). Tea tree oil is another natural antifungal, but make sure it is not swallowed by children or pets.
- Tannins. According to The Gale Encyclopedia of Alternative Medicine (Longe JL, ed. Farming-ton Hills, MI: Gale Group, 2001), these astringent polyphenols, found in tea and wine, can help cradle cap by controlling excess oil production, a possible cause of the condition. Warm black tea, German chamomile tea (Matri-caria recutita), burdock tea (Arctium lappa) or diluted witch hazel extract (Hamamelis virgini-ana), rubbed into the skin with a cloth several times a day, are recommended.
- Aloe vera. A crude extract of aloe vera (A. barbadensis), applied topically, was effective in con-trolling symptoms of sebor-rhoeic dermatitis in adults (J Dermatol Treat, 1999; 10: 7-11).
- Homeopathy. Low-dose systemic oral mineral (nickel and bro-mide) therapy was able to greatly improve the symptoms of sebor-rhoeic dermatitis in adults (Altern Med Rev, 2002; 7: 59-67). However, for children, it may be best to consult a qualified homeopath.
Nutritional deficiencies-specifically, deficiencies of the B vitamins biotin, riboflavin and pyridoxine-are associated with seborrhoeic dermatitis-like eruptions in infants (Am Fam Physician, 2006; 74: 125-30). Injected or intravenous biotin to either the infant or the nursing mother may help against cradle cap (Pediatrics, 1969; 44: 1014-6; Arch Dis Child, 1975; 50: 871-4), although oral biotin didn't help (Med J Aust, 1976; 1: 584-5; Arch Dis Child, 1981; 56: 560-2). So, to determine whether a nutritional deficiency is at the root of your son's cradle cap, consult a qualified nutritionist, who can also look for Candida albicans, another possible cause of the condition (J Eur Acad Dermatol Venereol, 2004; 18: 13-26).
If the problem persists or starts to spread, see your GP to rule out another diagnosis. Some skin conditions, such as atopic dermatitis (eczema), can mimic seborrhoeic dermatitis (Dermatol Ther, 2006; 19: 73-82), in which case, environmental irritants would be worth investigating.