Baby acne, or neonatal acne, is common and usually clears up on its own. Some rashes may need treatment, however, so it is important to know the difference between baby acne, rashes, and other skin problems.

Babies have very sensitive skin, so caregivers may worry that spots or a rash are a sign of an allergic reaction or a health condition.

In this article, we look at how to tell the difference between baby acne and common rashes, plus home remedies and how to prevent baby acne.

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It is common for a baby to have acne on the face.

Baby acne, or neonatal acne, is common and affects around 20 percent of newborns before they are 6 weeks old. It is most common on the face, but it can present on the neck, upper back, and chest. It is rare elsewhere on the body.

In adults and teenagers, hormonal swings and clogged oil glands commonly cause acne. This might occur due to using makeup, sweating, and applying skin care products.

Maternal hormones cause baby acne. Some babies are born with acne, while others develop it soon after birth.

Baby acne often appears as whiteheads, or closed comedones. Some babies also develop red pimples and mild skin inflammation. In rare cases, a baby may develop serious acne that can leave scars or become infected.

Baby acne does not usually need treatment, but when symptoms are severe, a doctor may choose to prescribe antibiotics or other treatments.

Baby acne typically starts before a baby is 6 weeks old. A rash or spot that appears after 6 weeks could be a result of something else. Babies who develop acne after the age of 6 weeks should see a dermatologist for diagnosis and treatment.

Rashes and other skin conditions are very common in newborns and can arise for many reasons. Some can look similar to acne. A few common skin conditions in babies include:

Contact dermatitis

Contact dermatitis results from coming into contact with something that irritates the skin, such as a lotion, cream, material, or metal. Contact dermatitis can look like red bumps or flattened areas of red irritation.

Allergens, irritating substances such as citrus juice, and wet skin from drooling can all cause contact dermatitis. This type of rash is more common in older babies who have started eating solid foods, and it is most common around the mouth.

It usually clears on its own, but if the rash gets worse, a doctor might prescribe a steroid cream or other treatment.

Heat rash

A heat rash, or miliaria, occurs when sweat glands are blocked. Some common causes include overheating, sitting in front of a space heater, and being held too tightly against a person’s skin.

Keep the baby’s skin cool and dry. Avoid very tight or warm clothes, especially in the summer. Heat rashes usually go away on their own.

Erythema toxicum

Erythema toxicum is a rash that starts a few days after birth. The rash is blotchy and red, with blisters that have a small white or yellow center.

An estimated 48–72 percent of full-term infants will experience erythema toxicum. It is harmless and will go away on its own within a few days.

Eczema

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A baby may inherit eczema if a member of their family has it.

Eczema is a skin condition that tends to run in families. Babies with eczema may have small patches of dry or thickened skin. More severe cases can turn the skin red and inflamed. Eczema patches are typically very dry and itchy.

Some babies experience eczema flares due to specific environmental triggers, such as dry weather, a new skin care product, and some food items. Identifying and avoiding these triggers can help.

Use a mild soap for eczema and avoid scrubbing the skin. Some caregivers find that less frequent bathing also helps. Put eczema cream on the affected patches after each bath.

Many infants outgrow eczema by 4 years old.

A number of over-the-counter (OTC) skin creams can make eczema less itchy. Corticosteroid creams, which use a mild steroid to speed healing, can also help. Though these are available over-the-counter, it is safer to talk to a doctor before using them on a baby.

Milia

Milia are small, firm, white bumps on the skin. They are very common, affecting nearly half of newborns. They may be present at birth, or they may develop shortly after.

Milia are harmless and will disappear without treatment. They form when skin flakes or keratin get trapped under the skin.

Transient neonatal pustular melanosis

Transient neonatal pustular melanosis is a common skin condition in newborns. It appears as small pus-filled spots. It is harmless and will go away by itself.

This skin condition is more common in newborns with black skin. The spots usually disappear within 5 days of birth, but they may leave dark marks on the skin for several months.

The spots usually appear on the following body parts:

  • forehead
  • neck
  • upper chest
  • chest
  • thighs
  • small of the back

Is it an allergic reaction?

Allergic reactions can cause raised, swollen bumps, or hives, to appear on the skin.People do not tend to confuse hives with acne. This is because hives is very uncommon under 6 weeks old, does not look like acne, and is usually not confined to the face, neck, and upper chest back as baby acne is.

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Products for adult skin can be harmful to babies.

Babies’ skin is thinner than adults’ skin and has fewer oil glands. This makes their skin more vulnerable to injury and irritation.

Adult acne remedies can irritate babies’ sensitive skin. Caregivers should avoid using OTC remedies unless a dermatologist or pediatrician suggests otherwise.

To treat baby acne at home, keep the skin clean but do not overmoisturize it. A gentle cleanser for sensitive skin can help. Avoid touching or picking at acne, which can make it worse and cause infections.

For most young babies, the fewer things that touch their skin, the better. However, if the baby has dry skin and a face moisturizer may work, it is best to use one that manufacturers have specifically designed for use on baby skin.

Though there is no clinical evidence supporting this claim, some caregivers claim that a breast milk remedy can work. Breast milk is rich in antibodies, and some believe that applying it to a baby’s acne can help clear it up more quickly.

Baby acne typically goes away on its own within a few weeks. If it does not go away, or if it gets worse, a person may wish to consider seeing a doctor.

Exposure to certain maternal hormones usually causes baby acne, which means that there is nothing specific that a caregiver can do to prevent it.

However, a few strategies can prevent acne from getting worse and reduce the risk of developing acne between 3 and 6 months:

  • Avoid using oily skin care products.
  • Monitor how various skin care products affect a baby’s skin. It is important to note that some babies are very sensitive to fragrances.

It can be difficult to tell baby acne from other types of rash, such as contact dermatitis, eczema, and erythema toxicum.

When other symptoms accompany the acne or another skin condition, talk to a doctor. Sometimes, a change to the condition of the skin can warn of a more serious problem, such as an infection or a problem with a baby’s hormonal system.

For most babies, acne is only temporary and will go away on its own. Caregivers who are unsure or who are concerned that their baby’s acne is very severe should see a doctor.