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Gentle washing or emollient use with brushing to remove scale is considered first-line treatment of infantile seborrheic dermatitis, or cradle cap (SOR: C, expert opinion). Ketoconazole 2% shampoo and 1% hydrocortisone cream, while equally effective (SOR: C, case series), may be no better than placebo (SOR: C, consensus opinion). Ketoconazole shampoo for 10 to 30 days does not produce measurable serum levels or raise liver enzymes (SOR: C, case series). Potent topical steroids are associated with acute reductions in serum cortisol levels, but low-potency steroids are not (SOR: C, case series).