Q&A 264.4

Olive oil treatment for cradle cap—can it worsen the condition?

Prepared by UK Medicines Information (UKMi) pharmacists for NHS healthcare professionals

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Date updated: 21st October 2015

Background

Seborrhoeic dermatitis is a common inflammation of the skin, occurring in areas rich in sebaceous glands. Seborrhoeic dermatitis in infants most commonly affects the scalp and is often known as 'cradle cap'. The face, ears, neck, and nappy area can also be involved. On the scalp, cradle cap presents as a scaly, crusty skin rash; the scales are yellow-brown, large, and greasy. Cradle cap usually appears in infants up to six months old, but most frequently occurs between the third and eighth week of life. It usually resolves within several weeks to several months (1,2).

The cause of seborrhoeic dermatitis is unknown. Malassezia yeasts, in particular Malassezia furfur (previously known as Pityrosporum ovale), have been implicated. Hormonal fluctuations may also be involved (3).

Cradle cap does not usually trouble the infant. Often no treatment is required but if necessary, simple measures are recommended, for example baby oil, baby shampoo, or olive or vegetable oil (1,3,4).

It has been suggested that olive oil can encourage the proliferation of Malassezia yeasts and worsen the condition (2).

Answer

Malassezia yeasts thrive in oily environments (5,6). Malassezia furfur is a lipophilic organism that grows in vitro only with the addition of C12 to C14 fatty acids such as olive oil and lanolin (5).

It has therefore been suggested that the use of olive oil for cradle cap may worsen the condition as it provides ideal conditions for the proliferation of Malassezia (2,6).

No published clinical trials evaluating the use of olive oil to treat cradle cap have been identified. In addition, no case reports of worsening of the condition with the use of olive oil have been found in the medical literature.

Guidelines from the New Zealand Dermatological Society recommend against the use of olive oil (2) but other sources suggest that it is not a problem in clinical practice (1,4,7).

Summary

 Cradle cap in infants is a form of seborrhoeic dermatitis. Treatment is often unnecessary but suggested management options include the use of baby oil, baby shampoo, or vegetable oils, such as olive oil.

 The cause of seborrhoeic dermatitis is unknown but Malassezia yeasts, in particular Malassezia furfur have been implicated.

 Malassezia yeasts thrive in oily environments, especially vegetable oils. It has been suggested that olive oil can encourage the proliferation of Malassezia furfur and worsen the condition.

 No evidence has been found that the use of olive oil for cradle cap leads to a worsening of the condition in clinical practice, and there seems no reason to change current recommendations. If the condition is not improving however, it may be preferable to use an alternative baby oil based on mineral oils.

Limitations

  • These recommendations relate solely to the management of cradle cap in healthy, immunocompetent infants.
  • The data in this area are limited and of poor quality.
  1. National Institute for Health and Care Excellence, Clinical Knowledge Summaries. (Last revised in February 2013) ) Seborrhoeic dermatitis. Available from [accessed on-line 5/10/15]
  2. Ngan V. New Zealand Dermatological Society. Cradle cap (infantile seborrhoeic dermatitis), last updated 15th December 2014. Available from [accessed on 21/10/15].
  3. O’Connor NR, McLaughlin MR, and Ham P. Newborn skin: Part I. Common rashes. Am Fam Physician 2008; 77: 47–52.
  4. Paediatric Formulary Committee. BNF for Children (online) London: BMJ Group, Pharmaceutical Press, and RCPCH Publications. Available from [accessed on 21/10/15].
  5. Wolff K, Katz SI, Goldsmith LA et. al. Fitzpatrick's Dermatology In General Medicine. 7th Edition. McGraw-Hill Publishing 2008: p1828. Available from [accessed on 6th March 2013].
  6. Siegfried E., Glenn E Use of olive oil for the treatment of seborrheic dermatitis in children Arch Pediatr Adolesc Med 2012; 166: 967
  7. South Australia Women's and Children's Health Network. Cradle Cap, last updated 14th May 2015. Available from [accessed on 21st October 2015].

Quality Assurance

Prepared by

Vanessa Chapman, Trent Medicines Information Centre, Leicester, LE1 5WW

Date Prepared 21st October 2015

Checked by Susan Carr, Trent Medicines Information Centre, Leicester, LE1 5WW

Date of check 21st October 2015

Search strategy

  • Embase, Medline, Pubmed, AMED, CINAHL, BNI ((cradle adj cap OR Dermatitis, Seborrheic OR seborrheic dermatitis) AND olive adj oil)
  • BNF for Children ( accessed 21st October 2015)
  • Clinical Knowledge Summaries ( accessed 5/10/15)

 Evidence in Health and Social Care ( accessed 21st October 2015)

  • Cochrane Library

1

Available through NICE Evidence Search at