Babies are prone to rashes and other skin problems. Baby acne and eczema are two skin conditions that are common. Both cause rash-like patches on the skin, and it can be tricky to tell the difference between them.

Acne is an inflammatory disorder related to the oil glands that connect to hair follicles in the skin. Eczema, which is also called dermatitis, is a condition that causes dry, flaky, and itchy skin. There are several types of eczema.

Both baby acne and eczema are treatable, and the symptoms are usually temporary.

This article outlines the characteristics of baby acne and eczema and explains how to differentiate between them.

Baby acne, or neonatal acne, is a common skin condition that affects an estimated 2 in 10 newborns. It usually resolves without treatment after a few weeks or months.

Baby acne tends to develop at around 2 weeks of age, but it can appear at any point before 6 weeks. In some cases, a baby may have acne from birth.

Parents and caregivers should take a baby to see the doctor if they develop acne after 6 weeks of age, at which stage doctors classify it as infantile acne.

Infantile acne is rarer than neonatal acne, only affecting about 2 in 100 children. It usually lasts for between 6 months and a year, but it can persist until the child’s teenage years.

Scientists are unsure as to what causes baby acne, but they believe that overactive oil glands, as well as testosterone and other hormones, may contribute to infantile acne.

Symptoms

Symptoms of baby acne are similar to those of adult acne. These are typically breakouts of spots and pimples that tend to appear on the face, neck, chest, and back.

In some cases, a child may also experience other symptoms such as abnormal hair growth that can indicate an underlying hormonal problem.

Eczema refers to a group of conditions that cause red and inflamed areas of the skin that sometimes may itch. Eczema usually develops between the ages of 6 months and 5 years.

Types of eczema include:

Eczema affects more than 30 million people in the United States. Atopic dermatitis specifically affects nearly 10 million children. Statistics also show that African American children tend to have more severe symptoms.

However, about 8 in 10 children outgrow it by the time they become teenagers or adults.

Symptoms

The symptoms of eczema include:

  • dry skin that itches
  • red or inflamed patches
  • dark patches of skin
  • rough or scaly skin
  • crusty or oozing skin
  • areas of swollen skin

Although baby acne and eczema can look quite similar, they require very different management. Due to this, it is essential to understand how to differentiate between them.

Baby acne vs. eczema

Neonatal acne tends to develop in the first 6 weeks of life. Infantile acne typically develops between the ages of 3 and 6 months.

It typically presents as white pimples or red spots. Infantile acne tends to include blackheads and whiteheads as well as pimples and spots, and it may also cause cysts.

Eczema usually appears between 6 months and 5 years of age.

People may mistake eczema for a different type of rash on the skin. For babies under the age of 6 months, eczema will usually appear red and weepy. If it becomes infected, the skin can develop a yellow crust or small lumps that contain pus.

Appearance on the skin of color

In cases of acne, adolescents with darker skin may experience more scarring than those who are white. Scarring is far less likely to occur with acne that affects babies or young children.

In cases of atopic dermatitis, they may experience more raised bumps as opposed to flat inflamed areas. With both conditions, children with darker skin can experience hyperpigmentation.

In general, it may be more difficult to see either acne or eczema on darker skin. Identifying the conditions may need to depend more on the texture of the breakouts and whether the child experiences any irritation or pain.

Affected areas of the body

The two conditions tend to affect different parts of the body, although there is some overlap.

Baby acne breakouts tend to occur on the:

  • forehead
  • chin
  • scalp
  • neck
  • upper back
  • upper chest
  • cheeks

In the first 6 months of life, eczema will usually appear on the:

  • face
  • cheeks
  • chin
  • forehead
  • scalp

Eczema often develops on a baby’s elbows and knees between 6 and 12 months of age.

It will sometimes also spread to other areas, but it does not affect the diaper area. A rash in this area may be a diaper rash.

Baby acne and eczema require different treatments.

Baby acne

Neonatal acne will usually go away by itself within a few weeks or months. It does not generally require treatment.

The American Academy of Dermatology offers the following skin care tips for babies with neonatal acne. A person should:

  • never use acne wash or treatment unless a doctor advises it
  • be gentle and avoid rubbing or scrubbing the affected areas
  • use lukewarm water and avoid hot water
  • avoid any oily or greasy skin care products

Infantile acne also usually clears up by itself, but this may take significantly longer. It can persist for 6 months to a year, and some children will experience acne up until their teenage years.

In some cases of infantile acne, a healthcare professional may prescribe antibiotic cream or gels to prevent scarring.

Eczema

While there is no cure for eczema, several different treatments can help ease the symptoms. The most appropriate treatment depends on the type, location, and severity of the condition.

It is vital to always speak with a doctor before using home remedies and other treatments on babies or infants.

A doctor may recommend moisturizers to treat mild eczema. These can relieve itching and protect the skin from germs and substances that may irritate it, such as pollution or laundry detergent.

Learning to identify triggers and avoid exposure to them can play a significant role in managing eczema.

In more severe cases, a doctor may recommend special soaps, shampoos, or steroid creams.

People may also confuse other skin conditions, such as erythema toxicum neonatorum and chickenpox, with baby acne or eczema.

Erythema toxicum neonatorum is a harmless skin condition that may occur within the first couple of days of life. It causes small spots and pimples of 1–4 millimeters in diameter on the arms and legs. Notably, the rash does not appear on the palms of the hands or the soles of the feet.

It typically clears up by itself within 5–14 days.

Chickenpox is a contagious skin disease that causes a rash of blister-like spots and pimples on the stomach, back, and face. The rash can spread across the whole body and tends to occur alongside itching, tiredness, and fever.

Chickenpox can lead to severe complications in babies, so anyone who suspects chickenpox in a baby should take them to see a doctor immediately.

The following are answers to frequently asked questions on acne and eczema in children:

How does healing look in baby acne vs. eczema?

Baby acne will gradually improve, with fewer new pimples and spots appearing as a baby gets older.

The appearance of healing with eczema can vary a lot. Often the dryness and scaling improve first, and then the redness fades and the patches become smaller. Darkening or thickening of the skin may take a lot longer to go away.

Is a rash on the ears or head eczema or baby acne?

Both baby acne and eczema can occur on the forehead and the scalp. Both conditions can also occur on or behind the ears.

Learn more about ear eczema and acne pimples in the ear.

Can kisses cause baby acne?

Kisses cannot cause baby acne. Aside from hormones, environmental irritants that can trigger baby acne include certain skin products, milk, or spit-up. However, environmental irritants are more likely to cause eczema than acne.

What are milk spots?

Milia, which are also called milk spots, are tiny white cysts under the skin containing keratin. This can affect 40–50% of newborn babies. While it may look similar to acne or eczema, a doctor should be able to tell the difference.

Can baby acne or eczema flare up from nursing?

Nursing a baby may actually lower the risk of eczema. In addition, putting some breast milk directly on an acne or eczema rash may help soothe irritated skin.

Baby acne and eczema may look similar, but the treatments and timescales are different, so it is important to know the difference.

Neonatal acne will usually resolve with no treatment within a few weeks or months. Infantile acne may take longer to clear up, but it does not typically need treatment.

Eczema is a long-term skin condition for which there is no cure. It often disappears by the time a child reaches adulthood. Many different treatments are available to help ease the symptoms on a day-to-day basis.