Baby Rashes: Acne & Nevi & Milia. Oh My!
Updated: Jan 18, 2021
All About Baby Rashes
Here is a list and information on baby rashes that are very common but will not cause your baby any problems and do not require any medication or intervention. Most will go away on their own with time, although the timeframe can vary depending on the rash.
Baby acne, or neonatal acne, is just what it sounds like, acne that occurs in infants, usually around one month of age. This baby rash consists of small red or white bumps that resemble "pimples" and "whiteheads". This rash is triggered by residual maternal, or sometimes, infant hormones. You should avoid trying to pop your baby's pimples, using any abrasive products on your baby's skin, or applying lots of moisturizers or creams. This baby rash will often spread before it starts to improve but will eventually go away on its own. However, this rash often takes several weeks to clear completely but will usually clear by the time your baby reaches two months of age. Wash your baby's face with gentle soap and water and do not apply any lotion or other moisturizers to his/her skin to prevent any worsening of this rash.
You may also hear this baby rash called erythema toxicum neonatorum. This rash consists of red spots on the skin, often with overlying white bumps. These can appear anywhere on the body and may cluster together. This baby rash usually shows up a few days after birth. It will not cause your baby any problems and will go away on its own in several days to a couple of weeks.
These baby rashes or lesions may also be referred to as "strawberry" or capillary hemangiomas. These lesions are not usually present at birth but may become apparent within the first several days after birth. This is due to the fact that these lesions often grow in the first six months of life, then tend to shrink, and may eventually disappear. Treatment is not usually needed for these lesions.
However, if your baby has a lesion on the face, head, or lower back, if their hemangioma is very large or is growing rapidly, or if it appears more bluish or purple (more likely a deep hemangioma that originates deeper in the skin), your child may require treatment. You should talk to your child's pediatrician right away, who may recommend your child see a pediatric dermatologist or other specialist if your child's hemangioma falls into any of these categories.
Milia are tiny white or yellow bumps that commonly appear on baby's faces, often on the chin or around the mouth or nose and often in groups. These bumps occur when skin flakes get trapped in small pockets near the surface of the skin. This baby rash will clear on its own within days to a few weeks. You do not need to do anything other than normal gentle cleansing of your baby's skin with soap and water.
You may know this baby rash by the somewhat outdated term "Mongolian spots" but the actual term is congenital dermal melanocytosis (not as easy to remember or say). This baby rash consists of flat, bluish patches that often cluster together and often present on the back and buttocks. However, they can sometimes present on the shoulders, arms, or legs. These lesions are much more common in babies with brown skin, because they naturally have melanin, or pigment, in their skin. These lesions occur when this pigment concentrates in one area. Some may call these "birthmarks" but they do eventually fade, but often not until a child has reached adolescence. These lesions will not cause your baby or child any problems.
This baby rash is also known as transient neonatal pustular melanosis and consists of fluid-filled bumps that eventually rupture and leave behind brown spots and sometimes a small amount of scale or dry skin. This rash usually appears a few days after birth and usually resolves on its own in days to weeks, but can persist for months. The rash can appear on any part of the body. No treatment is needed as this baby rash will not cause your baby any harm, and as in the name, is transient, meaning it will go away on its own with time.
You may have heard the terms "salmon patch", "angel's kiss" or stork's bite" to describe this baby rash, or the medical term, nevus flammeus simplex. The above nicknames relate to the fact that this rash is often seen on the forehead or eyelids ("angel's kiss") or the back of the neck ("stork's bite") and is usually reddish or peach-colored, like salmon ("salmon patch"). It also commonly occurs in the scalp and can occur in several or all of these places at the same time. This rash is a vascular lesion, meaning it originates from the blood vessels close to the surface of the skin. This baby rash may seem to be a birthmark; however, it will eventually fade, many in the first year of life and most by 18 months of age. This rash will not bother your baby or cause any problems.
Sebaceous hyperplasia, or sebaceous gland hyperplasia consists of flat, white or yellow spots, usually grouped together on the nose, but can occur on the cheeks or chin of infants, areas where sebaceous glands are most concentrated. This baby rash is caused by high secretion of sebum in infants, particularly full term infants (seen less in premature infants) and residual hormones transferred from the mother's placenta. You should continue to clean your baby's skin gently with soap and water but these spots do not cause any harm and will go away on their own, usually within the first few weeks of life.
If you think you baby has one of these rashes, talk to your baby's pediatrician at one of their regularly scheduled visits to confirm that it falls into the category of one of these benign rashes that will go away on it's own and does not need any treatment. If your baby's rash does not seem to fall into one of these categories, you may want to schedule an appointment sooner to talk with your baby's doctor. If you think your baby may have "cradle cap" (seborrhea capitis) or eczema/atopic dermatitis, check out my posts "Cradle Cap & Dandruff: What Really Causes It and How to Treat" and "Eczema! Oh Eczema!" that talk about how to manage or treat these rashes.
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Patrizi A, Neri I, Virid A, Gurioli C. Frequent newborn skin diseases. https://www.researchgate.net/publication/318347487_Frequent_newborn_skin_diseases
McLaughlin, MR, O'Connor NR, Ham P. Newborn Skin: Part II. Birthmarks. https://www.aafp.org/afp/2008/0101/p56.html
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