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Seborrheic Dermatitis and Pityriasis Capitis (Cradle Cap)

Peter Foley, MD, FACD; Yeqin Zuo, MB, GradDipEpidemBiostat, MPH; Anne Plunkett, BN, MPH; Kate Merlin, BMRA, GDipHSc (Health Promotion and Health Education); Robin Marks, MBBS, FACD

Arch Dermatol. 2003;139:318-322.

Objective  To determine the prevalence and severity of seborrheic dermatitis and pityriasis capitis in Australian preschool-aged children.

Design  A stratified cross-sectional skin survey using cluster sampling of centers throughout Victoria, Australia.

Setting  The study population included children attending child care centers, preschools, and Maternal and Child Health Centers, with the reference population being Australian children 5 years and younger.

Participants  Of the 1634 children in the original sample, 1116 children aged 11 days to 5 years 11 months were included in the study.

Intervention  Parents completed a questionnaire recording demographic information and personal and family history of skin problems and related diseases. A dermatologist performed a total skin examination, including the diaper area for children younger than 12 months.

Main Outcome Measure  The age- and sex-specific prevalence rates and site and severity of seborrheic dermatitis and pityriasis capitis were measured.

Results  The overall age- and sex-adjusted prevalence of seborrheic dermatitis was 10.0% (95% confidence interval [CI], 8.2%-11.7%): 10.4% (95% CI, 7.8%-12.9%) in boys and 9.5% (95% CI, 7.0%-12.0%) in girls. This was highest in the first 3 months of life, decreasing rapidly by the age of 1 year, after which it slowly decreased over the next 4 years. Most (71.9%) had disease classified as minimal to mild. Pityriasis capitis occurred in 41.7% (95% CI, 38.8%-44.6%) of the 1116 children examined, with 85.8% categorized as minimal to mild only.

Conclusions  Seborrheic dermatitis and pityriasis capitis are common in early childhood. Most children have minimal to mild disease that would require little if any treatment. Education programs directed at those caring for preschool-aged children are needed to provide information on simple preventative measures and treatment, if necessary, that could easily reduce the morbidity associated with these very common conditions.

From the Department of Medicine (Dermatology), The University of Melbourne, St Vincent's Hospital Melbourne, Fitzroy, Australia. The authors have no relevant financial interest in this article.

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