👶 Cradle Cap in PLAB 2: What to Know & How to Explain It to Parents
- Ann Augustin
- Jul 27
- 3 min read
Updated: Jul 27
As a doctor preparing for PLAB 2, you may be presented with a station involving a concerned parent whose baby has flaky patches on the scalp. This station tests your ability to:
Recognize cradle cap
Differentiate it from more serious conditions
Use clear, empathetic communication
Provide appropriate management and safety netting
This guide provides:
Clear clinical understanding
Simple lay explanations
Useful phrases to use in PLAB 2 consultations
A comparison with seborrheic dermatitis
🍼 What Is Cradle Cap?
Cradle cap (medical term: infantile seborrheic dermatitis) is a harmless, self-limiting skin condition seen in infants, especially in the first 3 months of life.
🔎 Clinical Features:
Greasy, yellow or white flaky scales on the scalp
May also be seen on eyebrows, ears, eyelids, neck, or diaper area
Not itchy or painful
The baby is usually well and unbothered
🧠 Why It Happens:
Overactive sebaceous (oil) glands, influenced by maternal hormones
Overgrowth of Malassezia, a type of yeast that lives on the skin
🗣️ How to Explain Cradle Cap (Lay Terms):
“This looks like cradle cap, which is very common in young babies. It’s completely harmless and not contagious. It happens because your baby’s skin is still adjusting after birth, and oil glands may be a bit overactive. The skin may look flaky or greasy, but it doesn’t hurt or bother the baby.”
🧴 Home Treatment:
Daily wash with mild baby shampoo
Apply baby oil or coconut oil 15 minutes before washing to loosen scales
Use a soft baby brush to gently remove flakes
Most cases resolve within a few weeks to months
🚩 Safety Netting Advice:
“Please bring the baby back if the skin becomes red, swollen, or starts oozing, or if your baby seems uncomfortable. If it doesn't improve with regular care, we can review it together.”
🧔♂️ What Is Seborrheic Dermatitis?
Seborrheic dermatitis is a chronic, relapsing inflammatory skin condition that can occur in adolescents and adults. It affects areas rich in oil glands, like the scalp, face, and upper chest.
🔍 Clinical Features:
Red, flaky, greasy patches with yellow scales
Most commonly on the scalp (dandruff), but also:
Eyebrows
Nasolabial folds
Behind the ears
Chest or back
Often itchy and may feel sore
Can be worsened by stress, cold weather, or immunosuppression
🧴 Management:
Medicated shampoos: ketoconazole, selenium sulfide, zinc pyrithione
Topical antifungals or low-potency corticosteroids
Requires ongoing management for flare-ups
🆚 Cradle Cap vs Seborrheic Dermatitis – Key Differences
Feature | Cradle Cap (Infants) | Seborrheic Dermatitis (Teens/Adults) |
Age Group | Infants (usually <12 months) | Adolescents and adults |
Location | Scalp, eyebrows, ears, neck, diaper area | Scalp, eyebrows, face, behind ears, chest |
Appearance | Greasy yellow/white flakes, minimal redness | Red, greasy, inflamed skin with yellow scales |
Itching | Usually not itchy | Often itchy |
Discomfort | Baby usually appears well | Can be sore, irritated |
Cause | Maternal hormones, Malassezia yeast | Malassezia yeast, oily skin, chronic inflammation |
Chronicity | Self-limiting, resolves over time | Chronic, may relapse |
Treatment | Gentle care at home | Medicated shampoos/creams may be needed |
🗣️ Phrases to Use in PLAB 2 Exam
🧑⚕️ Reassurance:
“This is very common and harmless. It’s not caused by poor hygiene and doesn’t cause any long-term issues.”
“It usually goes away on its own, but we can support the skin to recover with simple steps at home.”
🩺 Explaining Why No Medication:
“Because this usually clears up without any treatment, we don’t usually need to prescribe anything unless it becomes infected or persistent.”
🧑⚕️ When Comparing with Seborrheic Dermatitis (if parent has older children or asks):
“It’s similar to dandruff in older children or adults, but the baby version is milder and not usually itchy.”
🎯 Final Tips for PLAB 2
Use clear, empathetic language
Avoid jargon—say "flaky skin" instead of "scaling", "greasy patches" instead of "seborrheic plaques"
Always reassure and safety net
Know red flags and when to escalate
If unsure, always offer follow-up and parental support
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