Head gneiss


Head gneiss (ICD-10 number L21) is the popular or slang term for the so-called "seborrheic eczema" of newborns.

This is an inflammation of the skin due to the increased production of sebum. The term "grind" can be used synonymously. Other synonyms that are often used in technical jargon are Unna's disease or seborrheic dermatitis.
The head gneiss is often incorrectly equated with the cradle cap, which is the first occurrence of neurodermatitis (atopic eczema) in newborns (see also: Atopic dermatitis in babies).

The head gneiss is a yellowish, scaly skin rash that mainly affects the hairy scalp (gneiss) and the adjacent skin areas, such as the face, but also with severe infestation the spine or the chest.

Read more on this topic at: Rash on the forehead

The scaly rash (eczema) may be accompanied by itching. The disease is particularly common in newborns under 3 months of age. In addition, head gneiss can reappear in the 4th decade of life. Not every form needs treatment, but around 5% of those affected suffer from a form of head gneiss that needs treatment.
Men are affected slightly more often than women. The rash typically has a phased course, which is characterized by the alternation of mild and severe phases of the disease.


The cause of the occurrence of head gneiss is not yet fully understood. It is known that the Increased sebum production takes place and Skin fungi are involved in the development, which is why the affected skin areas become inflamed. Since most of the sebum glands are found in the hairy areas, head gneiss also occurs mainly on the head.
If one innate disposition plays a role is discussed, but has not yet been proven.
Since head gneiss occurs more frequently in males (both in infancy and in adulthood) than in females, the influence of male sex hormones (androgens) is also considered.
Because immediately after the birth the concentration of the male sex hormones (Androgens) is still increased, as these were transmitted via the mother, head gneiss occurs mainly in the first month of life. As soon as the concentration of the hormones drops, the head gneiss usually disappears again - so the assumption.
Many adults affected also report that stress and climatic conditions play a role.


Often the head gneiss, especially in babies, no complaints and is not perceived as disturbing by the babies. It is characterized by a scaly, yellowish rash, which mainly affects the hairy scalp and occurs especially in the first few weeks of life. In the vast majority of cases, it heals without any consequences by the time he is one year old.
The rash usually does not itch. However, itching can occur in exceptional cases. However, adults with gneiss suffer from this more often.

The rash is greasy and firmly adhering. As it progresses, the crusty rash turns brownish. For most of them, treatment is not necessary as the eczema heals on its own without consequences.
If the head gneiss is subsequently infected with fungi or bacteria (often from scratched areas), itching and other inflammatory symptoms such as fever, vomiting and diarrhea can occur. However, this is relatively rare.

Other parts of the body outside the head area can also be infected. In these cases, itching and inflammatory symptoms such as redness and pain are more common. Other affected parts of the body can be the axillary folds, the chest and spine area and, less often, the abdomen.
Scraping or roughly removing the scales can cause light bleeding of the skin and, as it heals, scars. Therefore, one should absolutely refrain from scraping off the scales.


Head gneiss is a clinical diagnosis. For this, the time of occurrence, the condition and the symptoms are decisive. This allows between Head gneiss and Cradle cap can be distinguished. The head gneiss is through maternal hormones raised during the cradle cap Signs of allergy-prone skin can be. The cradle cap itches, the children are impaired in their general condition. The head gneiss is usually not even noticed by children.


The head gneiss should be up to third month of life heal. The cradle cap, on the other hand, can persist until the age of two.

Unpleasant odor of the head gneiss

Occasionally, the head gneiss can smell unpleasant. Many parents describe the smell of head gneiss in their infants like "rancid milk" or "cheesy". The smell can develop from one moment to the next and is not a reason to panic.

Two important components in the formation of head gneiss are one excessive sebum production by the sebum glands the skin and a Increase in the population of Mallassezia yeastn. The latter belong to the natural colonization of human skin and have no disease value.
In the case of head gneiss, however, this creates a greasy rash that is not very breathable. The smell is due to the fact that the skin can hardly "breathe" under this layer of fat.

The smell per se, however, has no disease value and must not as a sign of severe infestation or the like are rated.
If the smell is very annoying, it is advisable to care for the baby's scalp with baby shampoos and baby oil or olive oil and gently remove the gneiss.


In the vast majority of cases, head gneiss heals itself without any consequences. Removing the scaly eczema is therefore not absolutely necessary.
Parents can try that if they want Gently remove dandruff with the help of olive oil or baby oil. To do this, it is advisable to rub the baby's scalp with the oil and leave it on overnight.
The next morning you can gently rinse your hair with some baby shampoo and carefully comb it out with a sponge or comb.

Repeating the procedure can make it easier to remove the flakes. However, one should never attempt to remove the flakes without such pre-treatment or soaking, such as scraping off. This can lead to bleeding and scarring as it heals. In addition, this results in small skin injuries, which can also lead to a subsequent fungal or bacterial infection.

If these measures do not help and the head gneiss is particularly pronounced or even symptomatic (i.e. itchy or painful for the baby), it is advisable to have a treatment carried out by the pediatrician.
The pediatrician often uses for treatment antifungal shampoos (effective against fungi, see also: Antifungal agents) or Shampoos and ointments with salicylic acid (antibacterial). In rare cases, too ointments containing cortisone (see also: cortisone) is used.
Anti-dandruff shampoos or the like should not be used on babies. You should also refrain from using Vaseline.

If you are unsure which ointment or tincture can be used, you should definitely see a pediatrician, as babies can be sensitive to various substances that are harmless to adults.

In adults, the course of the head gneiss is mostly chronic, so that removing the scales is not as easy as it is in children. It is often a dermatological therapy with various active ingredients such as antimycotics, calcineurin inhibitors (relieve inflammation and itching by regulating cells in the immune system), cortisone-containing preparations and sodium bituminosulphate (soothes irritated skin and counteracts increased sebum production).

Oils for the therapy of head gneiss

Oils can help soften the scaly rash in babies and allow the scales to be removed gently.
It is advisable to use olive oil and baby oil in particular, as these oils do not cause any allergic or inflammatory skin reactions.

You can apply it gently to the affected areas of the skin and massage in gently. In the case of strong head gneiss, the oils can also be left on for a few hours or, preferably, overnight. The next day, remove the oil with gentle baby shampoos. This softens the skin and especially the crusty scales.

This procedure should be repeated a few times until the scales can be carefully combed out or wiped off with a soft sponge.
However, one should refrain from using other oils, especially essential oils. They can cause an allergic reaction or inflammation in the infant. Oils should also not get into babies' eyes.

How can I best remove head gneiss?

To remove gneiss painlessly, you should use warm water or Baby oil removed.

Head gneiss on the eyebrows

Head gneiss and scab can also appear on the eyebrows. The head gneiss comes into the seborrhoeic areas which are located on the forehead, among other places.

Head gneiss in adults

Head gneiss can also occur in adults. This is treated in the same way as with children.

Differentiation from cradle cap

Cradle cap and head gneiss are often incorrectly used synonymously, as they can be very similar in their appearance. However, they are different skin rashes, which also differ in their causes and how they develop.
The cradle cap is the Initial manifestation of atopic dermatitis in infancy. This means that this is the first time this disease has occurred in an infant. Atopic dermatitis is also known as Neurodermatitis. This is indicated by a chronic existing rash. It is not curable, but treatable.
The head gneiss, on the other hand, is a seborrheic rash (originating from the sebum glands) in babies, which heals within the first year without consequences. As a rule, it is not chronic.

The following features can also be used to differentiate:

  1. Start: The head gneiss usually begins in the first weeks of life, especially in the third week. The cradle cap, on the other hand, usually does not begin before the third month of life.
  2. Duration: The head gneiss usually heals within the first year of life. It can rarely survive until elementary school age. It often heals within the first 3 months of life. With cradle cap, the course takes several months to 2 years.
  3. Course: Chronic courses are possible with cradle cap, but only in the rarest of cases with head gneiss.
  4. Cause: The cause of the cradle cap is very diverse. The head gneiss, on the other hand, is derived in particular from the sebum glands and is associated with an overproduction of sebum.
  5. Symptoms: The head gneiss hardly itches, has soft and fatty scales and generally does not impair the general well-being of the affected babies. In the case of cradle cap, there is sometimes very pronounced itching with hard scales and an impairment of the general condition.
  6. Treatment: While the cradle cap partially follows a step therapy, depending on the degree of severity, therapy is only very rarely necessary for head gneiss except for nourishing baths for the skin or nourishing baby oils.

Please also read our topic: Cradle cap