What to know about baby acne

People tend to associate acne with puberty and a person’s teenage years, but it is relatively common for a baby to get acne.

The causes and treatments of baby acne, also called neonatal acne, are different from those of adult acne.

This article will take a look at the prevalence and symptoms of baby acne. It will also list other skin conditions that people may mistake for baby acne and offer some practical management tips.

How common is baby acne?

Baby with acne and spots on face.
Baby acne is a relatively common condition.

About 20 percent of newborn babies will have neonatal acne. This tends to develop when the baby is around 2 weeks old, but it can occur at any time in the first 6 weeks of life. Occasionally, babies are born with neonatal acne.

Infantile acne is less common. It refers to acne that develops after 6 weeks of age. It typically occurs between 3 and 6 months. While it usually clears up within 6 months to a year, some children will have acne for longer, possibly through to their teenage years.

Baby acne is more common in males than females.


Causes

Doctors are unsure as to what causes neonatal acne. Testosterone causing overactivity in the skin’s oil glands may contribute to the development of infantile acne.


Symptoms

Neonatal acne will look like red spots or white pimples, rather than blackheads. These spots usually affect a baby’s cheeks and nose, but they can also develop on the:

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

Infantile acne usually involves blackheads and whiteheads, along with the red spots and pimples. It can also cause cysts, which can lead to scarring. It tends to affect the cheeks, chin, and forehead. It can also develop on the body, though this is less common.


Identifying baby acne and similar conditions

There are several skin conditions that people may mistake for baby acne. These include:

Erythema toxicum neonatorum

Erythema toxicum neonatorum is a common but harmless skin condition that can affect some newborns. Small spots and pimples of 1–4 millimeters across appear on the body, arms, and legs, but not on the palms of the hands or soles of the feet.

The rash will either be present when the baby is born or appear within 1–2 days of life. It will usually get better by itself within 5–14 days.

Chickenpox

Baby with chickenpox causing spots all over their body being held by mother.
Chickenpox often affects the whole body, whereas acne usually affects the upper body only.

Chickenpox, which the varicella-zoster virus causes, is a contagious skin disease. It causes a rash of blister-like spots and pimples, as well as itching, tiredness, and fever.

A chickenpox rash tends to start on the stomach, back, and face, but it can spread across the whole body. Baby acne, on the other hand, does not usually spread below the upper chest or back.

In babies, chickenpox can lead to serious complications, such as skin, brain, and bloodstream infections, dehydration, or pneumonia. Anyone who suspects that a baby has chickenpox should talk to a doctor.

Eczema

Eczema is a group of conditions that includes atopic dermatitis, contact dermatitis, and dyshidrotic eczema. Sometimes, it also includes seborrheic dermatitis, or cradle cap. However, this condition does not itch as other types of eczema do.

Eczema usually appears in the first 6 months to 5 years of life, and it looks like a rash.

If eczema develops when a baby is 6 months old or younger, it usually appears on the face, cheeks, chin, forehead, and scalp. The skin may appear red and weepy.

For babies between 6 months and 1 year old, eczema usually appears on the elbows or knees. If the rash becomes infected, a yellow crust or small, pus-filled lumps may develop.

Certain triggers can make a baby’s eczema worse. Such triggers may include:

  • dry skin
  • irritants
  • heat and sweating
  • infection

Bacterial folliculitis

Bacterial folliculitis is the medical name for an inflamed hair follicle. Infection and injury can cause bacterial folliculitis. Irritating substances, such as ingredients in creams or ointments, can also lead to folliculitis. Folliculitis is uncommon in babies.

This skin condition tends to look very similar to an acne breakout, but each spot may have a red ring around it. It can appear anywhere on the body, except on the palms of the hands and soles of the feet.

Herpes

Neonatal herpes is rare, affecting just 10 in every 100,000 births worldwide. It may cause a rash over the body, and babies with neonatal herpes can be very ill. Occasionally, though, it causes only cold sores or blisters around the lips and mouth, which caregivers may mistake for acne.

Antiviral medications are the most effective methods of treating the cold sores. However, these do not cure the infection itself. Cold sores will develop periodically for the rest of the child’s life.

Anybody concerned that a newborn has any type of herpes or cold sores should seek medical care right away.

Treatment and home remedies

Person bathing baby in water
Washing a baby in lukewarm water may help treat acne.

Neonatal acne does not usually require treatment.

According to the American Academy of Dermatology (AAD), baby acne tends to go away on its own within a few weeks to months. They advise caregivers never to use acne wash or treatment on a baby’s skin unless a doctor recommends certain treatments.

The AAD’s other tips for treating baby acne are to:

  • be gentle with the skin and avoid rubbing or scrubbing the acne
  • use lukewarm, rather than hot, water to wash the baby’s skin
  • avoid oily or greasy skincare products

A healthcare professional will usually diagnosis infantile acne after carrying out a physical examination. In many cases, infantile acne will not require treatment and will resolve by itself.

The healthcare professional may recommend a cream to treat infantile acne. Sometimes, they may prescribe antibiotics. In severe cases, where the acne may scar, they may recommend other pills or topical treatments.


When to see a doctor

Neonatal acne occurs when the baby is in the first 6 weeks of life. It is usually nothing to worry about and will go away on its own.

If a baby develops acne when they are older than 6 weeks, or infantile acne, a doctor should rule out other skin conditions.

Anyone concerned about their baby’s skin, or who suspects a condition such as chickenpox or eczema, should speak to a doctor.

Summary

Neonatal acne is not usually a cause for concern, and it tends to go away on its own in a few weeks or months. It does not tend to cause any scarring.

Caregivers may confuse baby acne with other skin conditions, such as eczema or erythema toxicum neonatorum. If in doubt about the diagnosis, a person should speak to their doctor.

Most cases of neonatal acne do not require treatment, though a doctor may prescribe creams where necessary.

Infantile acne also tends to clear up by itself, though severe cases may lead to scaring.

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