What is the most appropriate initial treatment for an infant with scale lesions on the scalp likely due to seborrheic dermatitis?

The most appropriate initial treatment for an infant with scaly lesions on the scalp that are likely due to seborrheic dermatitis is the use of warm olive oil compresses. This approach helps to soften and loosen the scales associated with seborrheic dermatitis, making it easier to remove them gently without irritating the infant's delicate skin. Olive oil is non-irritating, safe for use in infants, and helps to hydrate the scalp, which can assist in resolving the condition.

While selenium sulfide shampoo is an effective treatment for seborrheic dermatitis in older children and adults, it may not be the first-line treatment for infants due to concerns about the potential for skin irritation and sensitivity. Permethrin 1% cream rinse is typically utilized for treating head lice and is not appropriate for seborrheic dermatitis. Scrubbing the scalp with hexachlorophene is not recommended as it can be too harsh and poses risks of toxicity and irritation in infants' sensitive skin. Therefore, using warm olive oil compresses is a gentle and effective initial approach to manage seborrheic dermatitis in infants.