For new parents, babies usher in a whole new set of joys and a whole lot of new questions and concerns. So, when you start noticing newborn skin issues like small bumps, blotches or scaly patches on your newborn’s face or body, it’s natural to worry. Is it harmless baby acne or rash, or something that needs medical attention?
Newborn skin goes through a lot of changes in the early weeks, and most of what shows up is common and temporary. The American Academy of Dermatology reports that about 20 percent of newborns develop baby acne. A separate common rash called erythema toxicum shows up in as many as half of all full-term babies. Knowing what’s typical — and what’s worth having a medical provider assess — can take a lot of the guesswork out of those early weeks.
Baby acne, or neonatal acne, looks a lot like the acne you might remember from your teenage years. It typically appears in the first two to four weeks after birth as small red or white bumps on your baby’s cheeks, nose and forehead. It can also sometimes show up on the chin or scalp. It is generally harmless and short-term and clears up on its own without any lasting marks.
The exact cause of neonatal baby acne isn’t fully understood, but hormones passed to babies before birth and produced by new infants are likely culprits. These hormones affect how much sebum your baby produces. Sebum is an oily substance that protects their skin and hair, but too much can clog their pores and cause baby acne. Baby acne is more common in baby boys because they produce more hormones, including testosterone, in infancy. New infants also have very sensitive skin. Lotions and oils may clog their pores and cause acne, and food or vomit left on the skin for too long can cause newborn skin issues, too.
Baby acne usually clears within a few weeks to three months. It usually doesn’t need treatment, and in most cases, the best approach is simply to leave it alone.
However, acne that develops in older infants (usually three to six months old) is a different condition that should be evaluated by a medical professional to avoid discomfort and scarring.
“Rash” covers a lot of ground when it comes to newborn skin. Here are a few of the most common infant skin conditions you might notice in your baby’s first weeks and months.
This blotchy, red rash with small bumps is one of the most common newborn skin conditions, affecting up to half of all newborns. It tends to appear in the first few days of life and can show up on the face, chest, arms and legs. The bumps may contain fluid that looks like pus. ETN usually fades within a week and no intervention is needed.
Heat rash happens when sweat gets trapped under the skin. In infants, it tends to show up on the neck, shoulders, chest, armpits and elbow creases. It can look like clusters of small, inflamed blisters that are itchy or burn, or as clear bumps that don’t itch or hurt. It’s especially common in babies and young children, and it generally clears up once the skin cools down. Heat rash can look like bug bites, chicken pox, allergic rashes and other skin conditions. If it’s intensely painful or itchy, doesn’t improve within a few days or your baby shows any signs of infection, see a medical provider to rule out more serious conditions.
Yellowish, greasy or flaky patches on your baby’s scalp are cradle cap, a form of seborrheic dermatitis. It’s extremely common — about 70 percent of 3-month-olds get it. It’s rarely itchy or bothersome to your baby, and the treatment is to simply wash your baby’s hair with a mild shampoo more often. It typically clears up within the first year, but if the skin looks swollen, the scales are oozing or bleeding, the rash smells bad or your baby is uncomfortable, it’s time to see a medical provider.
This type of rash shows up when your baby’s skin reacts to something it touches — a new laundry detergent, urine in the diaper, drool, a fragranced lotion or a fabric that’s a little too rough. It can appear red, flaky, bumpy or swollen and is very itchy. It tends to appear only where the skin contacts the irritant, which can help you narrow down the cause and avoid it. Less commonly, allergies to things like latex, metals, plant oils, cosmetics or medicines can cause dermatitis.
Baby acne is often confused with milia, another common infant skin condition. Milia appears as tiny white bumps caused by trapped skin flakes rather than hormones or oil. It usually appears on the face but can also show up on the scalp, chest or even inside the mouth. Milia typically goes away within a couple of weeks with no treatment but may stay longer on older children.
Since several neonatal skin conditions can look similar, here’s a quick side-by-side to help you determine if it’s baby acne or rash.
| Condition | Appearance | Location | When It Appears | Duration | Visual ID |
| Baby Acne | Small red or white bumps, sometimes with a whitehead. | Cheeks, nose, forehead, sometimes chin or scalp. | 2 to 4 weeks after birth. | Several weeks to a few months. |  |
| Erythema Toxicum (ETN) | Blotchy red patches with small bumps, occasionally fluid-filled. | Face, chest, arms and legs; rarely palms or soles. | First few days after birth. | 5 to 15 days |  |
| Heat Rash (Prickly Heat) | Small inflamed blisters or clear bumps; may itch or burn. | Neck, shoulders, chest, armpits, elbow creases and groin. | 1 to 3 weeks after birth. | 1 to 3 days. |  |
| Sehorrheic Dermatitis (Cradle Cap) | White or yellowish flaky or oily, scaly patches. | Scalp; rarely on ears, eyelids, nose and groin. | 2 weeks after birth to 1 year old. | A few weeks to a few months. |  |
| Contact Dermatitis | Skin that is red, flaky, bumpy, swollen, oozing, blistering or cracked; may itch or be painful. | Wherever the skin contacts the irritant. | Any age. | 1 to 3 weeks. |  |
| Milia (Milk Spots) | Tiny white or yellowish bumps. | Face; less commonly on scamp, chest or inside the mouth. | Birth to a few weeks old. | A few weeks in newborns up to a few months in older children. |  |
If you’re ever unsure whether a skin change warrants a visit to a medical professional, it’s always reasonable to reach out and ask. Your baby’s pediatrician or urgent care provider are there to help with baby acne or rash.
When it comes to baby care, the internet is full of advice. Unfortunately, it’s not always accurate! Here are some myths worth clearing up:
Because they are common and generally benign, the treatment for baby acne and common rashes is primarily to keep your baby’s skin clean and dry.
For baby acne or rash, avoid heavy oils or creams and fragrances to avoid clogging your baby’s pores or further irritating the skin. And, tempting as it may be, never scrub a rash, pick at bumps or scales, peel dry skin or pop whiteheads or blisters. Doing these things can break the skin and cause an infection. To keep your baby from scratching at an itchy rash, put cotton mittens or socks on their hands.
If a rash doesn’t go away, a medical provider may conduct testing to pinpoint the cause and recommend OTC or prescription corticosteroids or antihistamines.
A newborn’s skin is still developing. A simple, consistent infant skin care routine is beneficial because it limits exposure to potential irritants. Following are some newborn skin care tips to help you keep your little one’s skin healthy.
Products aren’t the only things that affect your baby’s skin. Environmental factors like temperature and humidity also impact skin health. That’s, especially true here in the Pacific Northwest where you may take your kiddo from cold, damp weather into a toasty, dry indoor environment multiple times a day!
Dressing your baby in breathable layers will help regulate their temperature during unpredictable weather swings, and a cool-mist humidifier can take the edge off dry indoor air.
While the infant skin conditions we’ve covered are usually harmless, there are times that you should seek professional advice for newborn skin conditions. If you’re wondering when to see a pediatrician or visit urgent care, here are some signs:
A medical provider will be able to diagnose your baby’s condition and recommend a course of treatment to reduce discomfort and/or treat the underlying case.
Less commonly, rashes can indicate very serious or contagious conditions, such as measles, allergies, chickenpox, meningitis, hives, hand, foot and mouth disease, and others. If your child has any of the following symptoms with a rash, it’s important to visit the emergency room immediately:
In some cases, your pediatrician or urgent care provider may refer you to a pediatric dermatologist for a more in-depth look at your baby’s skin. These specialists treat conditions of the skin, hair and nails in children from birth through adolescence. On your first visit, the provider will take a thorough medical history, perform a physical exam and may order tests.
To get the most out of your appointment:
Newborn skin does a lot of adjusting in the first weeks and months of life. Baby acne and rash are very common, generally harmless and tend to resolve with little more than gentle, consistent cleaning. Knowing what’s normal to expect and what’s worth a second look at a medical provider’s office can help you feel steadier as you get to know your baby’s skin and develop your own infant skin care routine.
If you’re concerned about baby acne or rash, the team at BestMed Urgent Care is here to help. Walk in or book online to find the clinic nearest to you.
This article is for general educational purposes and isn’t a substitute for medical advice from your baby’s healthcare provider. Every baby is different, and a provider who can examine your baby is best positioned to make a diagnosis.