Q&A:
How should I treat my 16-month-old's flaking, itchy scalp?

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Answered by Anthony Mancini M.D.

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Dr. Mancini received his undergraduate and medical educations at the University of Arizona, and trained in pediatrics, pediatric dermatology, and dermatology at Stanford University. He is currently Associate Professor of Pediatrics and Dermatology at Northwestern University's Feinberg School of Medicine and Head of the Division of Dermatology at Children's Memorial Hospital in Chicago, Illinois.

Dr. Mancini has served as a member of the AAP Executive Committee, Section of Dermatology since 2001. He is a member of the AAP Super CME Planning Group and the AAP Pedia Link Pediatric Dermatology Project Team, and is Secretary-Treasurer of the Society for Pediatric Dermatology. His teaching accomplishments include the Faculty Excellence in Education Award from the Department of Pediatrics at Northwestern, which he has received for the last eight years. Dr. Mancini is a peer reviewer and/or sits on the editorial board for several academic journals, and has published over 75 peer-reviewed articles, abstracts, and book chapters. He is co-author of Hurwitz Clinical Pediatric Dermatology, 3rd edition, and is an associate editor for the comprehensive dermatology textbook Dermatology. His special interests include infectious skin diseases and exanthems of childhood, vascular malformations and hemangiomas, and neonatal skin maturation and skin disorders.

Dr. Mancini is a Fellow of the American Academy of Pediatrics and the American Academy of Dermatology. He and his wife, Nicola, a neonatal intensive care nurse, have three children (Mallory, Christopher, and Mackenzie) and reside in Evanston, Illinois.

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Question

How should I treat my 16-month-old's flaking, itchy scalp?

Answer

It really depends on the cause. Simple dry skin of the scalp usually causes no itching and does not need to be treated. On the other hand, some common scalp rashes, including seborrheic dermatitis ("cradle cap") and atopic dermatitis ("eczema"), can cause inflammation or itching in addition to the scaling. A useful tip for the flaking is to apply a few drops of baby oil to the scalp and gently massage the area before shampooing daily. If there is significant redness or itch, an anti-inflammatory cream (if she does not have much hair) or solution (if she does) is helpful, and should be discussed with her pediatrician. Finally, avoid over-the-counter shampoos marketed for dandruff or other scalp rashes, as they can be irritating to infant skin and will cause burning if they contact her eyes. Stick with a gentle, "no-tears" product made just for babies.