What Is Baby Acne?

Baby acne, also known as neonatal acne or neonatal cephalic pustulosis, occurs during the initial weeks after birth and causes whiteheads and red pimples on the infant's cheeks, nose, and forehead, although breakouts can also appear on the chin, scalp, neck, back, or chest. Baby acne occurs in up to 20% of newborns.

Symptoms of Baby Acne

Baby acne is temporary and typically develops within two to four weeks after an infant is born and lasts several days or weeks. In some cases, baby acne can last for several months.

Symptoms of baby acne, which may be more pronounced when a baby is crying or fussy, include:

• Red pimples
• Rough, bumpy rash
• Small white pustules or whiteheads

Baby Acne vs. Infantile Acne

If symptoms start at 3 to 6 months of age, this is known as infantile acne.

Like neonatal acne, infantile acne also generally affects the face and occurs more commonly in boys. This type of acne usually goes away on its own within three months to a year, but sometimes it can be more severe and carry a risk of scarring. As a result, long-term treatment with topical retinoids and antibacterials may be required. Testing for elevated levels of hormones is also done sometimes.

Most cases of infantile acne resolve by age 4 or 5, but some remain active into puberty. Babies with a history of infantile acne have an increased incidence of teenage acne. If your baby is developing acne, notify your pediatrician.

Diagnosis

Your pediatrician can diagnose newborn acne during a standard well visit by examining their skin. In addition, they may ask you whether you have a family history of acne and/or whether your infant could have come in contact with something that could have irritated their sensitive skin.

As part of the diagnosis, your pediatrician may rule out common skin conditions that newborns and younger infants develop that can be confused with baby acne, including:

Eczema

A red, inflamed, itchy rash that may be scaly, crusty, or oozy, eczema is an inherited form of skin sensitivity that causes extremely dry skin. It usually shows up around the three-month mark as dryness on the cheeks, but it may move to other parts of the body. Luckily, eczema tends to improve as babies get older and skin becomes less sensitive.

Erythema Toxicum Neonatorum

Up to 70% of newborns develop these pustules that are surrounded by a blotchy red area. The bite-like bumps usually appear during when babies are two or three days old (the cause is unknown) and go away after about a week without treatment, though they may reoccur for several weeks.

Heat Rash

Also known as miliaria or prickly heat, heat rash results when sweat glands become blocked and perspiration gets trapped beneath the skin. It affects up to 4% of infants and occurs most commonly in hot, humid weather. Heat rash, which looks like clusters of tiny bumps surrounded by red skin, usually resolves when the skin is allowed to cool off.

Infantile Seborrheic Dermatitis

Many parents know this extremely common rash as "cradle cap" because it occurs most commonly on the scalp, though other affected areas may include behind the ears, in the creases of their neck, arms, and legs, and the diaper area. Like baby acne, infantile seborrheic dermatitis often goes away on its own in a few weeks or months.

Milia

Half of newborns experience these tiny, pearly white or yellow bumps that are caused by an overgrowth of protein in the skin. They usually disappear on their own after a month.

Causes

The exact cause of baby acne is unknown, but some experts believe that exposure to maternal hormones during pregnancy plays a role. Since baby acne is more common in boys than girls, the involvement of elevated infant androgens (male hormones) may also be involved.

In addition, some research suggests an inflammatory reaction to skin colonization with Malassezia yeast is the cause of baby acne.

Other causes of baby acne may include:

• Allergic reaction
• Certain medications
• Sensitive skin irritated by milk, formula, or spit-up
• Viral illnesses

Treatment

Newborn acne is generally nothing to worry about; it doesn't harm your baby and is purely a cosmetic issue that rarely causes scarring.

Though rarely necessary, breakouts can be treated with the following topical medications. However, never apply treatment to your baby's skin without first consulting with your pediatrician:

• Azelaic acid cream (an anti-inflammatory)
• Benzoyl peroxide or erythromycin (antibacterial agents)
• Topical retinoids (to help keep pores clear)

Coping

A few simple steps can help you cope with and care for your baby's skin at home:

• Remind yourself that it looks worse than it makes your baby feel, and that baby acne will eventually go away.
• Gently cleanse your baby's delicate skin with lukewarm water (not hot) or with a mild soap.
• Avoid vigorous washing, scrubbing, and using moisturizers and other oily or greasy creams and lotions, which can exacerbate the problem.
• Don't pick, pop, or squeeze the blemishes.

A Word From Verywell

Baby acne can be distressing for parents, but keep it mind that it likely bothers you more than it bothers your infant. If you are concerned, talk with your pediatrician about the best way to treat your baby's acne, even if it's no treatment at all. And remember that this is a passing phase; clearer skin is on its way for your sweet bundle of joy.