Neonatal Acne: Everything You Should Know

Ok, 3 weeks after birth. We got this!…yellowing of my baby’s skin (jaundice) is going away, weird red ant-bite-looking things (erythema toxicum) are no longer all over her body, and he is finally sleeping just a tad better.

Now what in the world are these new red bumps on baby’s face? Your little one most likely has neonatal acne. Weren’t they supposed to experience acne when they grow older? NO! Babies can experience acne too. In this blog, we’ll take a closer look at what Neonatal Acne is and how to get rid of it.

What is Neonatal Acne?

Neonatal acne is a skin condition that causes red, tiny bumps on newborn face. The medical and scientific name for this condition is “neonatal cephalic pustulosis.” What a mouthful. It is no wonder pediatricians still just call this benign temporary condition neonatal acne or baby acne.

It looks quite similar to the pimples and breakouts with adult acne. Babies are not born with acne. 

Red bumps and what look like white heads (pustules) appear on the cheeks, forehead, chin, upper back, upper chest and even on the neck at 2 to 4 weeks of age.

In most cases, it is not harmful to the baby and usually clears up its own in a few weeks or months without causing scars. 

However, if you suspect that your baby is experiencing severe baby acne or is irritated by it, it is best to consult a pediatrician.

Is Baby Acne Normal?

Neonatal acne is very common in newborns. According to the American Academy of Dermatology, about 20% of newborns experience it,  but in my pediatric experience I would say it happens much more frequently.

It usually appears before the baby is 5 weeks old, and is most common in babies of 2 weeks of age. 

What Causes Baby Acne?

The experts are not sure about what exactly might be causing pimples in newborns. However, some of the common reasons are:

Mother’s hormones in the baby’s body

In teenage acne, hormones are usually to blame. When babies experience acne it’s mom’s hormones that can be blamed. The hormones transferred to the baby’s body before the birth can trigger their oil glands to produce more sebum. This sebum may clog the pores and cause pimples and bumps on newborn face. 

Malassezia Yeast

It is also hypothesized that neonatal acne may be associated with Malassezia yeasts that normally live on everyone from newborns to adults. As an inflammatory response to yeast, pimples and acne start to appear on the baby’s skin. It just so happens that the same yeast (fungus) is also the likely cause of cradle cap, seborrheic dermatitis, and dandruff.

Sensitive skin

Babies have delicate and sensitive skin, their pores are not fully developed which makes it easier for dirt, drool, sebum, or anything left on the skin to clog the pores. As a result, acne and pimples appear on the baby’s face.

Can Kisses Cause Baby Acne?

If you are not kissing your baby and are scared that it will cause acne on their face, please don’t be. Kisses are not related to causing acne on a baby’s face. It is mostly the hormones in the baby’s body.

However, excessive kissing can result in irritated skin and red rashes. Babies have sensitive skin and its natural barrier is still developing which makes it difficult for the skin to protect itself against the bacteria and viruses transferred from kissing. 

What Does Baby Acne Look Like?

Baby acne looks similar to the acne that we experience as an adult. It appears as tiny white or red bumps and pustules. Neonatal acne starts as tiny dots on the baby’s skin that later on turn into raised bumps with redness around them. 

Sometimes, These bumps are filled with liquid, giving them the iconic pimple look. However, it does not have any symptoms of blackheads (open comedones).

Learn more about Neonatal Acne from Dr. Eddie Valenzuela

• Baby Acne or Rash

Neonatal Acne Symptoms

Those tiny white pimples on your baby’s face are not confined to just one area. Neonatal acne may also appear on the baby’s

• Cheeks
• Neck
• Forehead
• Chin
• Scalp
• Nose
• Chest 
• Back 

Some common symptoms that may help you distinguish it from other similar skin issues like milia are:

• Clogged pores
• Small bumps 
• Red Papules
• White Pustules
• Redness around the pimples 
• Liquid filled bumps

The redness around the bumps and pimples may appear as red or pink in babies with lighter skin tones and purple in darker skin tones.

Neonatal Acne Vs Infantile Acne

Many people consider infantile acne, neonatal acne, and baby acne to be the same. But the truth is neonatal or baby acne is a little different from infantile acne. Baby acne usually appears in the first few weeks of your baby’s life–mostly before 6 weeks and disappears within a few weeks.

Infantile acne appears after 2 months of age and may take a long time to resolve. Sometimes it may persist until the baby turns 2 years old.

In case you are wondering about  what “infantile acne” can look like–in this condition you may see blackheads (open comedones). You will not see blackheads in “neonatal acne”.

Infantile acne can also cause scarring if it gets worse or proper treatment is not provided, and it is far less common than neonatal acne. 

Baby Acne or Eczema

Eczema also known as atopic dermatitis and baby acne are two very common skin conditions in babies. These conditions are often confused with each other because of their similar symptoms like redness, rashes, and small bumps on skin. However, both conditions are totally different and require different treatments. Learn more about the difference between baby acne vs eczema in this blog.

Acne mostly appears within the first 6 weeks of a baby’s life and eczema starts developing after 6 months of age. Baby acne is a temporary condition that will resolve in a few weeks but eczema is a chronic condition. This means that it may resolve on its own or it may persist in the form of eczema-flareups for a long time.

Eczema can be managed by keeping the skin clean with an eczema shampoo and body wash and moisturizing it with baby eczema cream. 

Neonatal Acne Vs Milia

Milia or milk spots are another skin condition that causes small bumps on a baby’s face. The bumps are usually white in color which makes it easy to distinguish from neonatal acne. 

The difference between both conditions is that milia causes cysts that develop under the skin and appear as tiny bumps on skin. 

Acne develops due to clogged pores on the skin and causes small red bumps on the skin that may appear as pustules and papules. Inflammation that we see in baby acne is not a symptom of milia and the milia bumps are smaller than those of acne. 

If you are curious about which of the two conditions your baby is experiencing then it is best to ask your pediatrician. 

How to Get Rid of Baby Acne?

Baby acne in most cases does not require any special treatment and usually disappears on its own. However proper care and attention given to the skin can help resolve it much faster. The best way to do it is by:

Keeping the Skin Clean

Keep your baby’s skin clean with a gentle cleanser every night. Make sure to use one that is specially formulated for your baby’s sensitive skin.  Since Malassezia yeast contributes to neonatal acne, using a gentle cleanser that can help reduce the activity of Malassezia yeast on the skin will soothe baby acne even faster–in days potentially instead of weeks. Pyrithione zinc is an active ingredient that helps control the activity of Malassezia yeast on the skin. Pyrithione zinc is found in Dr. Eddie’s Happy Cappy Medicated Shampoo, Face, and Body Wash. 

Happy Cappy is a cradle cap shampoo and can also be used as a face wash for baby acne and fungal acne. 

Don’t Use Adult Acne Products

The best way to treat acne in babies is to keep it far away from medications as much as possible. Especially the acne creams, face wash, and cleansers used by adults. Adult acne products contain harsh chemicals.

These chemicals can further irritate a baby’s delicate skin and lead to other skin issues like dry skin, flaky skin, and even trigger eczema. 

Don’t Pick or Squeeze

Squeezing or picking the pimples on the baby’s skin will only make the condition worse. The bacteria from our hands can also lead to other skin infections. So it is best to leave the pimples and breakouts alone. Just wash them, pat dry, and that’s all.

Topical Medications 

Topical agents are not commonly prescribed for neonatal acne. Acne first appearing after the age of 2 months old is possibly infantile acne and should be evaluated by a pediatric dermatologist who may prescribe topical acne medications. 

How Long Does Baby Acne Last?

Neonatal acne usually clears up within a few weeks or months. If a pediatrician has suggested the use of a neonatal acne cleanser then it may resolve in days.

A good thing about baby acne is it does not leave any scars. But if you suspect that your baby’s acne is not clearing up in a few weeks or months or is getting worse it is best to consult a doctor. 

Stages of Baby Acne Healing

Baby acne can either appear suddenly or start developing slowly. It starts as small bumps on the skin that take the shape of pimples. But how to figure out if it’s healing? We have got your answer.

Once the acne on the baby’s skin starts to heal the first thing that happens is the inflammation disappears. Then the redness around the pimples reduces. And finally the size of the pimples slowly starts reducing and after a week or so they disappear. Leaving your baby’s skin soft, clean, and blemish-free. 

When to See Your Baby’s Healthcare Provider?

So when should you talk to a doctor for your baby’s acne? If the acne does not get better after 2 months  of age or you notice any signs of it getting worse even after proper cleansing and care then it is best to consult a doctor. 

If you notice any of the following, consult your baby’s pediatrician, as they may be experiencing something else in addition to the acne breakout.

• Fever
• Fussy and irritated baby
• Skin blisters
• Peeling skin
• Skin infection
• The baby is not feeding well.

Key Takeaways

• Neonatal acne or baby acne is very common in newborns.
• Baby acne typically appears at 2 to 4 weeks of age.
• Baby acne is not harmful or contagious and usually disappears on its own after4 to 6 weeks.
• The best neonatal acne treatment is to keep the baby’s skin clean with a gentle baby face wash containing pyrithione zinc and not squeeze the pimples.

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