Neonatal Acne

Why does your newborn have baby acne and how do you treat it? We spoke to paediatric dermatologist Dr Tim Clayton about this common skin condition.

All babies have beautiful skin but some newborns develop spots on their face in the early weeks. Sally J Hall discusses this common skin condition in babies with paediatric dermatologist Dr Tim Clayton MB CHB MRCPCH FRCP(Edin) of DermExpert.

Many parents are quite surprised that babies can get spots too! Don’t worry, this is perfectly normal for newborns, and the spots will quickly get better without the need to do very much.

Milia In Newborns

As a paediatric dermatologist, I know that any little spot or blemish can be worrying for new parents. My advice would be to understand what’s normal, what you need to look out for and when you might need to seek out more help.

Some babies develop spots, pimples, or bumps on their face during their first few weeks. This is called baby acne or neonatal acne and usually, this is nothing to worry about. Acne can appear on any part of the face or body, though it is usually found just on the nose, cheeks, and forehead.

Babies are born with very sensitive skin and like many parts of their tiny bodies, it is still developing. It has just spent nine months inside you in the amniotic fluid, so it’s no surprise that the change from this to being in the air can cause a few skin problems! While we don’t know exactly what causes baby acne, it’s likely that the hormones that have been flowing around inside your body during pregnancy are to blame.

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Well, these hormones can stimulate the oil-producing glands in your baby’s skin, and this is the cause of those little spots that appear on your little one’s face. And in addition, your baby’s pores may become blocked by dead skin cells or dirt, and this may make the problem worse.

Dr Tim Clayton: These hormones usually start to cause problems from the second or third week of your baby’s life and may continue up to around their 12th week.

Your baby may have small red spots, raised bumps or what looks like a rash on their skin. Spots may be surrounded by clear skin, or there may be a collection of spots grouped together on a redder patch of skin.

Neonatal Acne: When Pimples Appear On Baby's Skin

Yes, there are some other skin conditions and rashes that might be mistaken for newborn acne. And naturally, parents may worry that there is an underlying cause for a rash. Here are a few to look out for:

It’s best to err on the side of caution and you should not try to do much about your baby’s acne. The dos and don’ts include:

Usually, baby acne clears up on its own but do speak to your doctor if it doesn’t clear up after a few weeks, if it looks very red or you think it is possibly infected. If your little one has a temperature, the spots have a discharge or look angry and inflamed, these may be indications of infection.

Does My Baby Really Have Acne?

Don’t worry, unless the spots are very large and inflamed, they usually do not leave scars. By the time your little one is a few months old, they will develop that wonderful peachy smooth skin.

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Baby acne is usually harmless and typically clears up on its own. Still, it’s important to know how to avoid aggravating the baby’s skin and when to bring your baby to a dermatologist to make sure the condition doesn’t require treatment.

Baby Acne (neonatal Acne)

“Very early neonatal acne is more likely an inflammatory reaction to a yeast overgrowth, ” said Robin Gehris, MD , a board certified adult and pediatric dermatologist at Riverchase Dermatology. 

It may start when hormones passed on from the mother just before she gives birth stimulate the glands that produce sebum, the oily substance that can clog pores. 

“Yeast that normally live on the skin, called Malassezia , flourish when sebum production increases in newborns. The yeast, in turn, creates inflammation that results in neonatal acne, ” said Dr. Gehris. “The condition is better termed neonatal cephalic pustulosis since the blackheads and whiteheads you see with true acne aren’t present, ” she added.

Just Bad Baby Acne?

Neonatal cephalic pustulosis (NCP) may appear when babies are about two or three weeks old and typically peaks at four to six weeks.

“Infantile acne is more what we consider to be true acne, ” said Dr. Gehris. It’s much less common than newborn acne, occurring in less than 2% of infants. Babies who develop infant acne usually get it when they are several months old.

The causes are unknown, but genetics may play a role. In some babies, the sebum-producing glands are overactive despite normal levels of androgens, the so-called “male” sex hormones. These hormones are a major factor in adult acne.

Is Baby Acne Common Among Newborns?

Newborn acne (NCP) can appear as small, greasy, red-pink pimples or red or white pustules (bumps filled