Cradle Cap vs. Eczema: What Are the Differences?

Cradle cap (infantile seborrheic dermatitis) and eczema (atopic dermatitis) are conditions known for dry, flaky skin. Though they’re closely related, these are distinct conditions. Cradle cap, seen in infants, typically resolves within a few months and affects the scalp; it doesn’t tend to cause discomfort or other symptoms.

In contrast, eczema can affect people of any age (though it’s primarily seen in infants and children under 6 or 7) and can be chronic, causing itchiness, burning, or redness on the skin.

This article explores the differences between these conditions, and their diagnosis, treatment, and prevention strategies.

Symptoms

Cradle cap and eczema have a lot of overlapping symptoms. Both cause characteristic flakiness and dryness of the skin; however, there are some key differences in how these conditions present.

Causes

Though both eczema and cradle cap are forms of dermatitis (inflammation or irritation of the skin), there can be significant differences in their causes. In both cases, however, more research is needed to identify the exact factors that lead to these conditions.

Cradle Cap Causes

Cradle cap is primarily recognized as an inflammatory skin disorder. Non-contagious, the symptoms arise due to dysfunction and disorder of the immune system. Several factors thought to be associated with cradle cap include:

• Overactive glands: Hyperactivity of the sebaceous glands in infants occurs due to higher levels of maternal hormone activity, leading to oily secretions that cause old, dead skin cells to stick to the scalp rather than fall off.
• Elevated fatty acids: Higher levels of fatty acids in the skin can lead to the formation of scaly, dry skin.
• Hormone levels: Because cradle cap only affects infants, elevated levels of maternal hormones and fluctuations in infants may lead to the condition.
• Yeast: Studies have found links between cradle cap and Malassezia, a yeast that causes high fatty acid secretion. Though this type of yeast is commonly found on the scalp, some individuals are more susceptible to developing symptoms due to exposure.

Eczema Causes

Researchers believe eczema arises as a result of genetic and environmental factors. Genetic factors may include:

• Filaggrin (FLG) deficiency: Insufficient production of the protein, FLG, affects the skin barrier, which prevents moisture from escaping the body. As a result, the skin can become more prone to infection and allergy, leading to eczema.  
• Inflammatory response: The itchiness and dry skin eczema causes have also been linked to immune system dysfunction caused by genetic mutations. This can disrupt the skin barrier and lead to an inflammatory response in the body, or pruritis, causing symptoms.
• Bacterial infection: Infection from the Staphylococcus aureus (S. aureus) (staph) bacteria can spur immune responses and cause inflammation, affecting the skin barrier.

Alongside genetic abnormalities, environmental factors and triggers can also lead to eczema. These include:

• Skin irritants, such as certain detergents, soaps, lotions, or cleaning products, as well as abrasive clothing, ointments, and bandages, among others
• Allergens, like pet dander, pollens, mold, or dust mites
• Shellfish, eggs, soy, wheat, peanuts, nuts, or other common food allergens
• Stress and worry
• Staph infection, herpes simplex virus, and yeast infection, among other types of infection

Diagnosis

There are no specific tests for cradle cap or eczema; healthcare providers rely on observation and assessment for diagnosis. Typically, this entails:

• Assessment of health history: Because there’s often a genetic component to eczema, healthcare providers first assess your family history of skin problems, including symptoms, current prescriptions, and current or past health conditions.
• Physical observation: A visual assessment of the affected skin, along with factors related to symptoms, such as recurrence and severity, are considered.
• Additional tests: Only if symptoms are suspected to result from another condition are specific lab tests requested. Generally, a physical exam and health history assessment are enough for diagnosis.

Treatment

Though you can effectively manage cradle cap and eczema, you should seek a proper diagnosis from your healthcare provider to consider appropriate treatment options.

Treating Cradle Cap

In mild cases, cradle cap resolves on its own within a couple of weeks to months. Treatment isn’t always necessary, though it can help more severe cases. The following home remedies are the first-line approach to treating cradle cap:

• Gently massaging the scalp or using a soft brush to loosen scales and improve blood flow
• Washing the scalp daily with gentle, child-safe shampoos while scales are present
• Brushing the child’s hair with a clean, gentle brush multiple times a day, especially after bathing
• Applying mineral oil to the scalp and wrapping it in warm, wet towels for about an hour before bathing

Other treatments may be required for more severe cases, especially if there’s an infection or other complications. These include:

• Mild, over-the-counter (OTC) corticosteroid creams
• Specialized anti-dandruff (antiseborrheic) shampoos, such as Sebulex
• Prescription antibiotics

Treating Eczema

Because eczema cases can vary in intensity and affect people differently, treatment approaches depend on the individual. A range of prescribed and OTC options can help manage the symptoms, including:

• Using topical moisturizing creams and lotions (emollients)
• Applying prescribed topical steroids, such as hydrocortisone
• Topical calcineurin inhibitors (TCIs), including tacrolimus ointment (Protopic) and pimecrolimus cream (Elidel), among others
• Topical phosphodiesterase-4 inhibitors (immune system-suppressing drugs, localized to the skin where applied)
• Systemic (body-wide) immunosuppressant medications (including biologics and Janus kinase inhibitors), antihistamines, and/or anti-allergy medications
• Ultraviolet B (UVB) therapy (exposes affected skin to specialized lighting)

Prevention

Though treatment can take on eczema and cradle cap flare-ups, there are also strategies to help prevent their onset.

Preventing Cradle Cap

Generally, strategies that treat cradle cap can also help prevent it. These include:

• Bathing and shampooing with gentle soaps daily when skin is flaky or at least twice weekly after flakiness has passed
• Brushing hair regularly
• Applying mineral oil to affected areas before shampooing

Preventing Eczema

The following can help prevent eczema flare-ups:

• Routine skin care regimen: Stick to a regular moisturizing skin care routine. Ensure the consistent and correct use of prescribed OTC medications, creams, and lotions.
• Daily baths: Some researchers recommend taking daily baths in warm—not hot—water, soaking for 10–15 minutes at a time; pat dry rather than rubbing intensely, and immediately apply moisturizer to lock in moisture.
• Avoid triggers: Allergens, such as certain foods, dust mites, and pet dander, skin irritants, including certain soaps and detergents, metals, or other cleaning products, can all cause eczema attacks. Tracking and avoiding these can help prevent flare-ups.
• Anti-inflammatory diet: Because inflammation can cause flare-ups, some recommend eating an anti-inflammatory diet, such as a Mediterranean diet, rich in fish and lean proteins, leafy greens, olive oils, and whole grains.
• Stress management: Stress is a common trigger for eczema attacks, so finding ways to manage stress through meditation, mindfulness, yoga, or exercise can help.
• Wet wrap therapy: This can help with symptoms and potentially assist in flare-up prevention. Dampen gauze or towels with warm water and lay it over affected areas for 10–15 minutes.

Summary

Though cradle cap and eczema both cause flaky, scaly, or irritated skin, the conditions have key differences. Cradle cap exclusively affects infants and children under 2, typically resolving on its own without the need for treatment.

Though eczema is more common in children, it can impact those of all ages and can become a chronic and recurring condition. Treatments and lifestyle changes can help manage and prevent these conditions; however, it's important to get a proper diagnosis from your healthcare provider first.

A Word From Verywell

Skin problems, like eczema and cradle cap, can impact your quality of life and affect confidence. Be proactive about getting help for your symptoms, especially if you have physical discomfort. The sooner you or your child gets the help you need, the better your outcome will be.