Baby Acne, Eczema, or Something Else? A Parent’s Guide to Common Baby Rashes
Baby Acne, Eczema, or Something Else? A Parent’s Guide to Common Baby Rashes
By Brett Mendez, MS, APRN, NNP‑BC • VitalStart Pediatrics, A Professional Nursing Corporation
If there is one thing babies seem to be especially good at, it’s developing mysterious spots, bumps, and rashes.
You bring home that beautiful, soft-skinned newborn, and suddenly there are little red bumps on their cheeks. Or maybe your 3-month-old develops rough, dry patches that weren’t there last week. Naturally, you start wondering: Is this normal? Is it eczema? Is my baby allergic to something? Do I need to call the pediatrician?
The good news is that skin changes are incredibly common during infancy, and many require little or no treatment. However, some rashes deserve a closer look.
Here are some of the most common skin conditions seen in babies, what parents can look for at home, and when I would want you to call your child’s healthcare provider.
Baby Acne
Yes, babies can get acne, and it can look surprisingly similar to teenage acne.
Baby acne usually appears as small red or white bumps, often on the cheeks, forehead, chin, or scalp. It commonly develops during the first several weeks of life.
Although parents understandably want to make the bumps disappear, baby acne generally doesn't require acne medication or aggressive skin care. In fact, doing too much can irritate your baby's sensitive skin.
What can you do?
Keep it simple:
Wash your baby's face gently with lukewarm water and a mild, fragrance-free cleanser if needed.
Pat the skin dry rather than rubbing.
Avoid scrubbing the bumps.
Don't squeeze or pop them.
Avoid using adult acne products unless specifically recommended by your child's healthcare provider.
Most cases improve on their own with time.
What About Those Tiny White Bumps?
If your newborn has tiny, pearly-white bumps, particularly around the nose, cheeks, or chin, you may actually be looking at milia rather than baby acne.
Milia are tiny cysts caused by keratin trapped beneath the surface of the skin. They are extremely common in newborns and are harmless.
You don't need to squeeze, scrub, or remove them. Milia typically disappear on their own.
Eczema
Eczema, also called atopic dermatitis, tends to look different from baby acne.
Rather than individual pimples or bumps, eczema often causes areas of skin that are:
Dry
Rough
Red or discolored
Scaly
Itchy
Occasionally cracked or irritated
In infants, eczema frequently appears on the cheeks, scalp, and outer surfaces of the arms and legs, although it can occur elsewhere.
What can parents do at home?
Good skin care is one of the most important parts of managing eczema.
Try:
Short baths with lukewarm rather than hot water
Gentle, fragrance-free cleansers
Thick fragrance-free moisturizers or ointments
Applying moisturizer soon after bathing while the skin is still slightly damp
Avoiding fragranced lotions, soaps, detergents, and other products that seem to irritate your baby's skin
If your baby's eczema is persistent, severe, interfering with sleep, or causing significant itching, talk with your pediatric healthcare provider. Some babies need additional treatment.
Also call if the skin begins oozing, crusting, becoming increasingly red or swollen, or developing sores, since irritated eczema can sometimes become infected.
Cradle Cap
Those yellowish, greasy, flaky scales on your baby's scalp are commonly called cradle cap, or infantile seborrheic dermatitis.
It can look dramatic, but mild cradle cap usually isn't dangerous and often improves with time.
Parents may notice:
Yellow or white scales
Flaky skin
Greasy or crusty patches
Mild redness underneath the scales
And despite the name, cradle cap doesn't always stay on the scalp. Similar irritation can sometimes appear around the eyebrows, ears, neck, or other skin folds.
Gentle washing and softening of the scales may help. Avoid aggressively picking or scraping them off.
Heat Rash
Babies aren't as efficient at regulating their body temperature as adults, and their sweat ducts can become blocked.
The result can be heat rash, which often looks like clusters of tiny red or clear bumps.
You may notice it in warm, covered areas such as the:
Neck
Chest
Back
Armpits
Skin folds
Keeping your baby comfortably cool and avoiding overdressing can usually help.
A good rule of thumb: more layers aren't always better. Babies can get overheated too.
Diaper Rash
Almost every baby will experience diaper rash at some point.
Typical diaper irritation causes redness and inflammation in the areas directly exposed to urine and stool. Frequent diaper changes, gentle cleansing, allowing the area to dry, and using a protective barrier ointment can help.
However, not every diaper rash is simply irritation.
A yeast diaper rash, for example, may appear especially bright red and can involve the skin folds, sometimes with smaller red spots surrounding the main rash.
If a diaper rash is severe, worsening, blistering, bleeding, spreading, or isn't improving with routine diaper care, it's worth having your pediatric provider take a look.
Drool Rash and Contact Irritation
Once the drooling starts, so can the rashes.
Saliva, milk, food, and repeated wiping can irritate the delicate skin around a baby's:
Mouth
Chin
Cheeks
Neck folds
Upper chest
Keeping the area gently clean and dry and protecting irritated skin with an appropriate fragrance-free barrier product may help.
And remember: a rash around the mouth does not automatically mean your baby has a food allergy.
So…How Do I Know What Rash My Baby Has?
Sometimes you don't, and that's okay.
Many infant skin conditions can look similar, particularly early on. Photos from the internet can be helpful for general education, but they aren't always a reliable way to diagnose your baby's rash.
As pediatric providers, we look at much more than simply whether a rash is "red."
We consider:
Your baby's age
Where the rash started
How quickly it appeared
Whether it is spreading
Whether it blanches, or temporarily lightens when pressed
Whether there are blisters, crusting, drainage, or open areas
Whether your baby has a fever
Feeding and hydration
Your baby's overall behavior and appearance
That last one is especially important.
When Should I Call the Pediatrician?
Contact your child's healthcare provider if you're unsure what you're looking at, particularly if the rash is getting worse rather than better.
I would especially want to know about a rash that:
Is rapidly spreading
Is painful or extremely itchy
Develops blisters or open sores
Has pus, drainage, significant crusting, warmth, or swelling
Doesn't improve with appropriate home care
Occurs along with poor feeding or decreased wet diapers
Is accompanied by fever
Is associated with a baby who simply isn't acting like themselves
A Special Note About Newborns
A rectal temperature of 100.4°F (38°C) or higher in a baby younger than 3 months requires prompt medical evaluation.
Don't assume a fever is caused by a rash, teething, or something minor. Young infants can become seriously ill quickly and may not show the same signs of infection that older children do.
When Is a Rash an Emergency?
Seek immediate medical attention if your baby has a rash along with:
Difficulty breathing
Swelling of the lips, tongue, mouth, or face
Blue or gray coloring
Extreme sleepiness, weakness, or difficulty waking
A seizure
Purple, dark red, or bruise-like spots that do not lighten when you press on them
Rapidly developing blisters or peeling skin
Signs that your baby is seriously ill
With young babies, it's always appropriate to have a lower threshold for getting them evaluated.
The Bottom Line
Babies get bumps. They get dry patches. They peel. They break out. They develop mysterious red spots that weren't there when you put them to bed.
Most infant rashes are harmless and temporary.
Your job isn't to become a pediatric dermatology expert. Instead, watch how the rash changes and, more importantly, how yourbaby is doing overall.
If you're concerned about something you're seeing on your baby's skin, take a picture so you can track how it changes and show it to your child's healthcare provider.
And when you're not sure?
That's exactly what we're here for.
This article is intended for general educational purposes and should not replace individualized medical advice, diagnosis, or treatment from your child's healthcare provider.