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Is It a Rash or Baby Acne?

Updated on July 29, 2019
JulieNyhus profile image

Julie Nyhus FNP-BC is a Family Nurse Practitioner who writes about health and wellness.

Baby Skin

Baby skin is different from adult skin in several ways. The layers of infant skin are about 30% thinner than adult skin but have a higher water content. This makes baby skin prone to dryness because moisture can be absorbed and released quicker. In addition, the sweat glands in infant skin are immature and less effective.

Your baby's skin is delicate and many factors can affect its condition. There are numerous types of newborn rashes, but here we will discuss four of the most common:

  • neonatal acne
  • milia
  • infant eczema
  • erythema toxicum

Call your pediatrician. Always consult a pediatrician or dermatologist prior to self-treating your baby's skin.

Baby Acne

Baby acne is benign and temporary.
Baby acne is benign and temporary. | Source

Baby Acne: Appearance

What is baby acne? Neonatal acne (or baby acne) is a type of newborn rash that is common and temporary. It can happen soon after birth, usually within the first few weeks of life and affects about 30% of newborns.

What does baby acne look like? This rash presents on the forehead, temples, or cheeks as red or white bumps surrounded by red, inflamed skin.

Baby Acne: Causes

No exact cause. Although doctors do not know the exact cause of neonatal acne there are some valid theories. The condition is thought to occur in response to maternal hormones, yeast living on the skin, or a reaction to certain formulas.

However, we do know that exposure to rough fabrics or certain detergents can make baby acne worse.

Look-alike rashes. Keep in mind that certain medications, allergic reactions, or viral infections can present similarly to baby acne by causing red pustules and inflammation. Always consult with your healthcare provider.

Baby Acne: Treatment

What can I do about neonatal acne? Treating neonatal acne requires that the affected areas be kept clean and dry.

  • Cleanse the area daily with a mild soap and water.
  • Avoid scrubbing the affected areas.
  • Never use acne products as they could damage the tender skin.

Newborn acne is a temporary condition that causes no discomfort and leaves no scarring. It will disappear on its own in a few weeks.

Infantile Acne vs. Neonatal Acne

What's the difference? Neonatal acne should not be confused with infantile acne which is rare. Here's how to recognize the difference:

Infantile Acne

  • Occurs later in life than neonatal acne.
  • Occurs between the ages of three months and one year.
  • Includes both pustules (whiteheads) and comedones (blackheads).

These infants should be seen and treatment by a pediatrician or dermatologist.

Milia

Milia is a common baby rash and often confused with baby acne.
Milia is a common baby rash and often confused with baby acne. | Source

Milia: Appearance

Where are milia located? Milia are common and can be mistaken for baby acne since they also present on the face. However, milia present as white bumps, not red.

What do milia look like? Milia will present as tiny white bumps on the nose, cheeks, or chin. There will be no redness.

Milia: Cause

Milia have a specific cause. Milia are caused by skin flakes trapped on the surface of the skin. Often babies are born with milia or it can begin to appear within hours or days after birth.

Milia: Treatment

Treating milia. It is important to keep the areas affected by milia clean and dry. Cleansing the area daily with a mild soap and water is enough. Both newborn acne and milia are temporary conditions that cause no discomfort and leave no scarring.

Here today, gone tomorrow. Just like newborn acne, milia will disappear on its own in a few weeks.

Here are some things to avoid:

  • Using lotions or creams for these types of rashes is not recommended by doctors.
  • Scrubbing the affected areas does not help and should never be done.
  • Acne products should never be used as they can damage a baby's tender skin.
  • Rubbing or pinching the bumps can worsen the condition and leave scars.

Eczema

Baby eczema can range from mild to severe and should be treated by your pediatrician or dermatologist.
Baby eczema can range from mild to severe and should be treated by your pediatrician or dermatologist. | Source

Eczema: Appearance

Eczema affects all ages. You may be familiar with eczema, an inflammatory skin condition, that affects children, adults, and elderly. But eczema can affect infants too.

Baby eczema is another common rash that can be confused with baby acne. It can initially present as red bumps just like newborn acne, however, with eczema red patches will always appear on the skin as well.

Patches and rough skin. The patches of baby eczema may ooze or crust over becoming a bit uncomfortable for your baby. The skin can appear rough and be itchy. Your baby's pediatrician or dermatologist can help you determine the best treatment for this.

Can affect whole body. While baby eczema can affect only the face at times, leaving both cheeks with red bumps and red patches, for some babies, it can become very diffuse, affecting the whole body. Arms, legs, trunk, and the backs of hands and feet can all be affected.

Eczema: Causes

Why does my baby have eczema? Infant eczema can result from irritating substances like perfumes, lotions, or bubble baths but most infant eczema does not have a known cause. Eczema usually shows up between one and five months of age.

Eczema: Treatment

Give it time. Some babies will outgrow infant eczema, while others continue to experience issues. Baby eczema can become troublesome if it lingers and may require a visit to the pediatrician or dermatologist and a steroid medication. Based on research, doctors often recommend specific creams and/or treatments to avoid flairs. Be sure to discuss these options with your baby's doctor.

Good news! With consistent, gentle skin care, eczema will improve and flairs can be controlled.

Erythema Toxicum

Erythema toxicum is benign and fleeting.
Erythema toxicum is benign and fleeting. | Source

Erythema Toxicum: Appearance

Common rash. Erythema toxicum is another common baby rash that can appear as red, tiny bumps or red blotches. The lesions often begin as small macules (flat, small spots) or papules (small, solid bumps). They range in size from 1 to 4 mm and progress to pustules (pimple-like bumps). The surrounding skin is red, thus the term "erythema".

This harmless condition often appears within the first days of birth, or sometimes within the first few hours of birth. Erythema toxicum can appear on the face, chest, arms or legs, sparing the palms or soles.

Erythema Toxicum: Causes

No known cause. The cause of erythema toxicum remains unknown. There are theories that have been postulated but no definite cause has been identified. Some medical experts think this condition could be a combination of the immature sebaceous glands and hair follicles in the baby's skin and microbes within the hair follicles.

Erythema Toxicum: Treatment

Fleeting rash. Erythema toxicum is self-limiting, disappearing within 5 -14 days after showing up. Keeping the skin clean and dry and avoiding lotions is the best treatment. Also, never pick or squeeze the pustules and always contact your baby's pediatrician if you have questions or concerns.

Which Rash Is It? Consider Location and Color

(click column header to sort results)
Rash  
Location  
Color  
Neonatal Acne
Forehead, temples, or cheeks
Red or white bumps surrounded by red, inflamed skin
Milia
Nose, cheeks, or chin
White
Baby Eczema
Cheeks, arms, legs, trunk
Red bumps and patches
Erythema Toxicum
Face, chest, or arms and legs
Red, tiny bumps or red blotches

Caution

Always consult a pediatrician or dermatologist prior to self-treating your baby's skin.

References

This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2019 Julie Nyhus FNP-BC

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