Crusts on a baby's head

Often in infants of the first year of life in the area of the hair is found a kind of flaking in the form of a light unaesthetic plaque. Such crusts on the head of the infant resemble dandruff, except that the size of the scales is much larger. Why does this problem arise, and are there safe and reliable ways to get rid of it?

Epidemiology

Crusts on the head are found in almost every second infant, so the problem is considered extremely common and does not cause any pronounced panic on the part of parents and doctors. Both boys and girls can equally have such a temporary cosmetic defect, which is able to disappear even without special treatment within a few months.

At infancy, the sebaceous glandular system is very active, and the sweat glands are located too densely, which negatively affects their correct functioning. Normalization of glandular function occurs around the age of seven.

The beginning of crust formation occurs in the first or second month of the baby's life. The prevalence of this problem in infants of the first three months of life varies within 70%.

Causes of the crusts on a newborn's head

Most often the reason for the formation of crusts is quite trivial: infants have very delicate and sensitive skin, the protective properties of which are not yet fully expressed. In addition, at an early age, thermoregulation and water-electrolyte balance in the body are not stable enough, which further predisposes to the appearance of skin diseases. [1]

All of the above processes are only a mechanism that creates certain conditions for the appearance of crusts on the head. And the leading role is played by the peculiarities of the function of fat and perspiration.

In infancy, the sebaceous glands are overactive, and the structure of sweat glands is too compacted. Normalization of glandular function occurs around seven to eight years, so the presence of crusts before this time can be considered a kind of norm. But we do not always have to talk about the norm, because the appearance of the problem is often associated with violations in the care of skin and hair of the baby. Therefore, other reasons for the appearance of crusts can become such:

• overheating of the child, resulting in increased sweating;
• Use of inappropriate shampoo, with a lot of unnatural synthetic ingredients;
• too frequent or, conversely, too infrequent washing of the head (optimally, according to doctors, washing hair every 4-7 days);
• allergic processes in the body, weakened immunity.

Risk factors

Specialists point to such basic factors of the appearance of crusts on the head of the infant:

• Improper nutrition (both the baby and the nursing mother);
• overheating or hypothermia of the scalp;
• improperly selected hygiene products;
• poor hygiene.

According to one of the assumptions, excessive activity of sebum during the newborn period is provoked by androgens - hormones that have entered the baby's bloodstream from the mother. With the removal of hormones from the baby's body, the work of sebaceous glands normalizes, but it takes time.

In addition, the state of the digestive system also plays a role in the formation of crusts. In a young child, the process of enzyme production is not yet sufficiently coordinated, so any new product in the diet can cause an allergic reaction, skin rashes, or the formation of scales on the scalp and behind the ears. Such a reaction is also observed against the background of a deficiency of certain vitamins.

In general, the following series of provoking factors can be voiced:

• allergy prone;
• stressful conditions;
• treatment with antibiotics, other medications;
• improper diet;
• disorders of the intestinal microflora;
• improper hygiene rules, incorrect selection of hygiene products.

Doctors note that the hereditary factor has no practical significance in the appearance of this problem.

Pathogenesis

The extreme prevalence of the problem of crusts on the head in infants is due to the imperfect structure of the sebaceous glandular system and high production of sebum, compared to that of adults. This disorder has a connection with many causes:

• High levels of hormones in the blood from the mother during intrauterine development;
• Increased synthesis of adrenocorticosteroid hormones in the baby;
• changes in the biochemical fat composition on the skin surface.

In some cases, the negative impact of the activity of the lipophilic fungal pathogen Malassezia is confirmed.

Imperfect thermoregulation in infants, wide temperature fluctuations (overheating and hypothermia of the baby) contribute to the aggravation of the formation of crusts on the head in the fall and spring period.

Symptoms of the crusts on a newborn's head

The main symptom is the formation of yellowish or cream-colored crusty scales on the scalp. These scales are located in small or large islands, but sometimes cover the entire scalp. The crust itself can resemble thick dandruff, but practically does not crumble, but is held on the skin: the hair sprouts through the plaque almost without problems. In some infants, the problem is also found behind the ear flaps, in the interbrow space.

The first signs of crusts appear around 14-20 days of the baby's life. Each scale can be easily scraped off with a fingernail: it usually comes off without any problems, wounds or bleeding. In older children - from about 2-3 years of age - the scaly plaque is drier. The dry crust comes off worse, and the quality of the hair deteriorates.

Crusts on the head very rarely cause an unpleasant sensation of itching, burning or pain in an infant. In most cases, it is just a cosmetic defect.

If crusts on the head and eyebrows of the infant are accompanied by the appearance of wounds, unpleasant sensations, scratching, then you should definitely see a doctor, as these may be symptoms of atopic or allergic forms of dermatitis.

The initial stages of scale formation may remain invisible for a long time, especially if the child has long, thick hair. But the lesion of the facial area becomes noticeable immediately: crusts appear in places with a large number of sebaceous glands. This is the interbrow areas, nasolabial triangle, the area behind the ear flaps. Often there is a combined lesion of the scalp and facial skin.

Forms

The crusts in question may be oily, dry, combined, pathologic, or physiologic.

Pathological elements include seborrheic crusts on the head of an infant, which are provoked by a specific fungal infection - yeast-like fungus Malassezia Fulfur. This is a conditionally pathogenic fungus that exists, feeding on skin sebum. Activation of the pathogen occurs when hygiene rules are not properly observed, or when immunity is weakened.

Yellow crusts on the head of an infant are not always pathological and may indicate physiological increased activity of the sebaceous glands. As a result, large scaly layers are formed, sticking together. Increases the oiliness of the skin, which often serves as a provoking factor for the activation of bacteria. If you do not observe the necessary hygiene, or ignore the problem, it can worsen, which is highly undesirable.

But the dry crust on the head of an infant occurs due to insufficient sebaceous gland function. Such scales sometimes cause itching, and when trying to scrape them off, the child may feel pain, expressing obvious anxiety. Hair growth with dry scales may be somewhat impaired, especially if the layer is quite dense.

Milk crusts on the head of a baby in most cases are physiological - that is, their appearance is due to certain processes in the child's body, which is characteristic of infancy. Experts reassure: if the baby does not bother anything, the physiological form does not need treatment and after some time is eliminated on its own, leaving no trace.

A red crust on the head of an infant should be alarming. This sign indicates the presence of blood in the scales: perhaps there were attempts to peel them off forcibly, or the child is itching and scratching the crust, damaging the skin. In such a situation, it is better to show the baby to a doctor.

When prescribing treatment, it should be taken into account that white crust on the head of an infant often refers to a combined type. This means that the treatment measures to eliminate the problem should be complex, using folk and traditional methods.

Complications and consequences

Most often complications with crusts on the head of an infant do not occur. But, if the problem is neglected, unpleasant consequences can still happen. For example, with massive widespread crusts, the baby sometimes has symptoms such as itching, headache, irritability, poor sleep, crankiness, crying without reason. Itchy scales can lead to severe scratching, up to the formation of scars. The same is observed in the case of improper, violent stripping of the crusts: in such a situation, even infection of the skin can be observed.

When do crusts on the head of an infant go away? Most often it happens about 4-7 months after their appearance, or until the age of 2 years. But in some children, the problem is delayed until 3-4 and even up to six or seven years old. To prevent this from happening, it is necessary to take measures to eliminate crusts as early as possible.

If you notice that the crusts on the head of the baby are wet, and the skin has become pinkish and swollen, then it can be assumed that it is not the usual gneiss, but a food allergic reaction. It is necessary to carefully examine the baby's body: perhaps there is a rash on the tummy, arms or legs. If the crusts are wet, then here the problem will not be solved only by soaking and combing them out. It is necessary to identify the source of the allergy, remove it from the diet (mother or child), and additionally conduct a course of anti-allergic treatment.

Diagnostics of the crusts on a newborn's head

For diagnosis, you should consult a pediatrician or pediatric dermatologist. Sometimes it may be necessary to consult an allergist-immunologist. A visit to the doctor is especially recommended if, in addition to crusts on the head of the infant, there is also itching, or other unpleasant symptoms.

The doctor will perform an examination, find out the presence of other diseases (including hereditary), and if necessary - refer for tests, or other studies.

Laboratory tests may be as follows:

• general and biochemical blood work;
• for a fungal infection;
• a blood sugar study;
• assessment of hormonal balance.

Instrumental diagnosis may include ultrasound of the thyroid gland, dermatoscopy (microscopic study of the skin structure, follicles, determination of hyperkeratosis).

Differential diagnosis

Differential diagnosis of crusts on the head is carried out with atopic dermatitis, eczema, lichen planus, psoriasis. But most often the diagnosis does not become difficult, because the appearance of crusts is quite typical.

Treatment of the crusts on a newborn's head

In most infants, crusts on the head eventually resolve on their own, without the use of hospital therapy. If treatment is still prescribed, its extent depends on the degree and significance of clinical symptoms, the duration of the problem, and the treatment tactics used previously.

The main goals of such treatment are:

• softening and mechanical removal of scaly crust;
• skin cleansing, strengthening local immunity;
• removal of hypersensitivity of the body (desensitization);
• preventing the development of secondary infection or eliminating it.

It is possible to use medications such as:

• Keratolytics (salicylic ointment, oil preparations to be applied directly to the affected area).
• Low-acting topical corticosteroids (0.1% hydrocortisone ointment, 0.1% prednisolone aceponate).
• Keratoregulating agents (glycerin, karite oil).
• Antiseptics and adsorbents (fucorcin, zinc paste).
• Anti-allergic agents (dimethindene, cetirizine).
• Antifungal drugs (external preparations with ketoconazole, ciclopirox, aerosols with zinc pyrithione).

For severe disease caused by fungal infection, antifungal oral medications may be prescribed from the age of 2 years:

• ketoconazole tablets are prescribed for children weighing 15 to 30 kg, 100 mg once a day;
• fluconazole in capsules is prescribed 50 mg once a day or 300 mg once a week for 14 days.

In general, it is recommended to establish a rational nutritional diet of the baby and his mother, to review the used detergents. It is recommended to use hypoallergenic shampoos on a natural basis, air baths.

How to remove crusts on the head of an infant?

You can speed up getting rid of crusts if you regularly soften them with oils - for example, ordinary vegetable oil or special baby oil. After softening (after about half an hour), the scales are combed out with a safe comb. Of course, such a procedure is easier to carry out if the baby has a short hair. Therefore, some parents for this purpose cut the child's hair, and only then proceed to treatment.

Instead of vegetable oil you can use vaseline oil, sea buckthorn oil, rosehip oil, etc.

In addition, to solve this problem, there are special baby shampoos labeled "anti-crust" or "antiseborrheic":

• Babe Laboratorios Cradle Cap Shampoo is a mild dermatocosmetic shampoo made in Spain.
• Mustela Bebe Foam is a French foam shampoo for newborn baby, it has a universal cleansing action.
• Babe pediatric - quickly gets rid of seborrheic crusts, acts on yeast fungal infection, promotes skin cell renewal.

Kokoso Baby anti-seborrheic cream made in the UK is also particularly popular. It is an effective product on an organic basis, so it acts gently and carefully.

How to remove crusts from a baby's head with oil?

The basic rule is: under no circumstances should the scales be forcibly peeled off. This will not eliminate the problem, but will make it even worse. To get rid of crusts, it is optimal to use oils. Any oil will do: vegetable oil, vaseline oil, turnip oil, sea buckthorn oil, and so on.

The sequence of the procedure is as follows:

• prepare oil, a blunt safety comb or comb, and a light cotton cap;
• apply the oil directly to the crusts between the hair (you can directly with your fingers, or with a cotton pad);
• after abundant application of oil on the infant's head put on a cap and wait at least half an hour (you can more);
• remove the cap and rinse the hair well with an antiseborrheic shampoo (or any other baby shampoo, if you are sure that it is not the cause of the problem);
• comb out the softened crusts well with a comb or comb.

Do not try to comb out all the scales at once. Most likely, you will need to perform several such procedures, which should not be performed more than once a week.

What to use to comb out crusted scalp in infants?

Comb out the crusts gently, without trying to forcefully tear off the crusts. Dry crusts should not be combed out: they must be softened beforehand, otherwise they can provoke wounds on the infant's head.

Do not use a comb with sharp teeth for the procedure. A thick, soft comb that will not hurt the skin, but will comb the hair well and wash easily, is suitable.

If you notice that your baby is unhappy and cranky during combing, stop the procedure: it may be painful. Try it again next time and be sure to soften the crusts well.

Medicines that your doctor can prescribe

In the vast majority of cases, there is no need for drug treatment of crusts on the head of infants. Only in prolonged and widespread course of the process may be prescribed some medications, for example:

Salicylic ointment 2%	The ointment is applied to the area of crust spreading up to three times a day (can be mixed with petroleum jelly). Duration of treatment - 1-3 weeks. In case of too frequent use or overdose, redness, burning, skin irritation may occur.
Pimafucort	Combined corticosteroid medicine is applied to the affected area up to 4 times a day, for the shortest possible period of time (the maximum allowable course of treatment is two weeks). It is prescribed only by a doctor for the treatment of children from the age of one year.
Cinocap	Aerosol with zinc pyrithione can be used in children from the age of one year. The product is sprayed on the affected area 2-3 times a day until the desired effect is obtained, as well as within a week after the disappearance of the problem. Side effects in the form of allergies are rare.
Dimethindene	An antihistamine drug that is prescribed in individual dosages. Depending on age, it can be used in the form of tablets or external gel. Side symptoms may include drowsiness, dizziness, dry mouth.
Cetirizine	As an anti-allergic agent is used in individually selected dosages. Possible side effects: increased fatigue, insomnia, irritability, palpitations.

Vitamins

Crusts on the child's head can appear both from allergic processes and against the background of vitamin deficiency in the body. Vitamin D is especially relevant: according to recent studies in children of the first three years of life hypovitaminosis D occurs in about 60% of cases. In the pharmacy sold a large number of monopreparations of this vitamin - for example, Aquadetrim, Super D, Multitabs vitamin _D3, etc. To date, it is generally accepted that the prophylactic amount of 400 IU of vitamin D per day is optimal for metabolic and other processes in the body.

However, it must also be taken into account that the formation of hormonally active D is only possible when the body is supplied with other vitamins such as:

• Vitamin A (supports the immune system);
• Vitamin C (needed for adequate steroidogenesis);
• B vitamins (provide metabolic processes);
• folic acid (promotes protein biosynthesis, in particular the production of protein receptor active form of vitamin D);
• vitamin K (takes part in post-translational modification processes of calcium-binding proteins).

Deficiency of vitamin D supply is a risk factor for crusts on the head in infants under one year of age.

Physiotherapeutic treatment

Physiotherapy is not fundamental in the treatment of crusts on the head of infants. But it can be a good addition to the general treatment scheme, because there are many procedures that are effective and at the same time safe for children. We are talking about the use of physical natural properties: light radiation, ultrasound, laser beam, magnetic field, etc.

Doctors prescribe physiotherapy as a therapeutic and preventive tool, to strengthen the immunity of the infant. Especially recommended are massage, hydrotherapy, and such procedures:

• Magnetotherapy - the method is an exposure to an alternating or pulse magnetic field at a low frequency. The procedure increases metabolism, stimulates blood circulation, improves trophic processes in tissues. At the same time there is a soothing, analgesic, anti-inflammatory and anti-edema effect. Low-frequency field affects gently and safely, can be prescribed to children from one year of age. The recommended duration of the session is 10-15 minutes, the course of treatment should consist of a minimum of six such sessions.
• DMV therapy is a high-frequency electrotherapy involving the application of ultra-high frequency electromagnetic waves in the decimeter range. The procedure can be performed from the age of two years. Sessions are carried out with an output power of 2-3 watts, for 5-7 minutes.

The need for a particular physical therapy procedure is determined by a pediatrician or pediatric dermatologist.

Folk treatment

• Dilute mumie in the ratio of 1 g to 1 liter of warm water. Wet the warm solution of hair and skin in the area of crusts. After about 0.5-1 hour wash the baby's head. The procedure is repeated daily or every other day.
• Prepare a soda solution of 1 tsp. Baking soda and 150 ml of water, wet the crusts on the head with it. Wash off after 30-40 minutes. Repeat the procedure 3-4 times a week.
• Take natural apple cider vinegar, apply a small amount of it to a clean soft cloth and apply it to the crusts for about 15 minutes. Then wash the infant's head in the usual way.
• Apply aloe juice to the crusts (after washing the head).

Herbal treatment

• Dandelion and burdock rhizomes are dried, ground in a coffee grinder. Take 2 tablespoons of powder, pour 500 ml of boiling water and insist under a lid for several hours. Give the child 2 tablespoons up to five times a day, before meals.
• One tablespoon of chamomile flowers pour 200 ml of boiling water, insist for half an hour. Soak the resulting infusion of crusts about half an hour before washing the head. At the same time, you can give the infusion and inside - one tablespoon 4 times a day.
• Prepare infant infusion of rose hips with valerian root: one tablespoon of rose hips and one teaspoon of crushed valerian root pour 500 ml of boiling water, insist overnight. Give the baby 1 tbsp. Three times a day.
• Pour 2 tbsp. Kalina 200 ml of boiling water, let infuse. Give the child 2 tbsp. L. Twice a day after meals.

Homeopathy

The use of homeopathic remedies in pediatric practice has become increasingly popular in recent years. Such remedies in properly labeled amounts are practically devoid of side effects and absolutely safe, including for children. The use of a competently selected homeopathic remedy allows not only to eliminate the cause of the appearance of crusts on the head of an infant, but also in general to improve health. Homeopathy stimulates each of the internal reserves of the body, which ultimately leads to normalization of all processes.

For infants with crusting on the scalp, these homeopathic remedies are recommended:

• Hamomilla - administered with a dilution of at least one-sixth, starting with low doses.
• Belladonna - recommended if crusts on the head of the infant are accompanied by other signs of allergies. Apply in a division of 3, 6, 12, or 30. If the allergic reaction is acute, it is allowed to take 5 drops every half an hour.
• Sulfur - is prescribed in the sixth dilution. Especially recommended if, in addition to crusts, the child is bothered by coughing or sneezing.
• Rus - helps with various dermatologic problems. Including, it is also used to eliminate crusts on the head of an infant. Suitable for 30 dilutions.

Getting rid of crusts can be a long process, especially if the baby is found to be hypersensitive or prone to allergic reactions. However, a comprehensive approach with the addition of homeopathic remedies to the treatment regimen always allows to speed up the solution of the problem.

Prevention

Each of us realizes that crusts on the head of the infant is easier to prevent, rather than then get rid of the scourge. Therefore, when buying products to care for the hair of the baby, it is additionally recommended to buy and special children's shampoo with antiseborrheic effect. Periodic use of such shampoo significantly reduces the risk of inflammation and inhibits the activity of fungal pathogens.

It is very important to regularly observe the condition of the skin and hair of the child, paying attention to discomfort, rashes, itching, the formation of scales. If any of the symptoms have appeared, and the baby is clearly showing anxiety, it is necessary to consult with a pediatrician.

Prevention is the usual careful observance of sanitary and hygienic rules, and proper nutrition - both the child and the nursing mom.

Often crusts on the head of a baby indicate an allergic mood of the body, so you should carefully analyze what the baby eats (or what the mother eats, if the baby is completely breastfed), what cosmetics are used for care and so on. It is noteworthy that not only insufficient, but also excessive intake of some vitamins and minerals in the infant's body can cause a negative reaction.

Forecast

The prognosis is considered favorable. Crusts on the head of an infant in most cases disappear without trace, subsequently having no effect on the development of allergic processes or dermatologic diseases. Even if the problem is not treated, it passes independently and finally by about 2-7 years of age.