Baby Acne Explained: Causes, Symptoms, And Treatments

Babies are delicate beings that require our undivided love, attention, and care. They rely on us for safety and stability. As their caretakers, it can be difficult to know what it is they need, especially during the first few months when they are still unable to fully express themselves. A lot of things can happen during the newborn period, and it can be scary for any parent when something unusual happens with their baby.

According to a 2017 article (via StatPearls), compared to adult skin, the skin of newborns is "thinner, less hairy, and has less sweat and sebaceous gland secretions." It is no surprise then, that some of the most common conditions that can be seen in newborns are those that involve the skin. They are the most easily recognizable ones as well. Many types of skin lesions can be seen in babies, such as peeling, discoloration, bumps, bruising, bald spots, skin tags, and moles (per Stanford Medicine). Most of these are benign, but others may be a sign of something more serious.

Acne is a skin condition that is common in teenagers and adults. Surprisingly, babies can develop acne as well. If your baby was born with acne, or they got it within weeks after they were born, don't worry — they may have a relatively common condition called baby acne (which is not to be confused with "bacne", a term used to describe acne on the back).

It may be difficult to distinguish baby acne from other skin conditions that can develop in newborns. In general, baby acne appears as small, red or white bumps on the face (per Healthline). It is often seen on the cheeks, and can sometimes develop on the upper back and neck as well. You may see white pustules or whiteheads, and the surrounding skin may be red. The lesions may last for days, weeks, or sometimes even months.

Cleveland Clinic adds that aside from the face, neck, and upper back, baby acne can also develop on the scalp. The lesions seen in baby acne can suddenly or slowly appear, and begin as dots that may progress to pimples. As time passes, the redness will slowly go away and the lesions will start to shrink. Unlike adult or adolescent acne and other skin conditions, baby acne completely clears, and does not lead to permanent scarring on your baby's skin. It also is not known to increase your baby's risk of developing acne when they start undergoing puberty (via What to Expect).

Treating baby acne is usually not necessary, since the lesions typically go away on their own. However, if your baby's lesions are persistent, a doctor may prescribe a medicated cream or ointment for you to put on your baby's skin. You should never use over-the-counter medicated products, as well as any facial washes or moisturizers, without consulting your baby's doctor first (via Healthline). A baby's skin is not built to tolerate products for older children or adults, and using these products may lead to more harm.

You can ask your baby's doctor for advice on what you can do at home to help with your baby's acne. According to Mayo Clinic, some of the things you may do include making sure that your baby's face is always clean; drying your baby's face gently by patting it dry; and avoiding manipulating (e.g., pinching, scrubbing, picking) your baby's lesions, as this can lead to further irritation and may even cause an infection. Wash your baby's face daily with warm water. You can use plain water one day then water with a mild, moisturizing soap the following day.

Per Pampers, you should avoid letting your baby's skin come into contact with sheets, blankets, or clothing that may have harsh laundry detergent residue, as this can irritate your baby's delicate skin. You can follow this by using laundry detergent that is specifically used for babies, or by placing a properly washed blanket under your baby's head.

According to the American Academy of Dermatology (AAD) Association, infantile acne develops in babies past the age of 6 weeks, typically appearing between their 3rd and 6th month of life. While infantile acne can clear on its own, it can leave permanent scars on your baby's skin, and may persist until adolescence. This is why unlike baby acne, infantile acne may be a cause for concern, and should be examined by a specialist (ie, board-certified dermatologist or pediatric dermatologist).

A 2022 article published via StatPearls explains that infantile acne may be related to a person's genetics, and may also be caused by increased sebum production as a response to circulating androgens in the body. Because of greater androgen production, male infants are more likely to develop infantile acne compared to female infants. Unlike baby acne, infantile acne is not that common, and affects less than 2% of children in the United States. However, it usually develops quickly, presents more severely, and may be accompanied by other symptoms (e.g., abnormal and excessive body hair, enlarged testicles in males, enlarged clitoris in females). These symptoms are rare but may be caused by a tumor in the adrenal gland, which is another reason why further evaluation is usually necessary with infantile acne. Although there is currently no approved treatment, infantile acne is often managed similarly to acne vulgaris if the lesions do not resolve on their own within six months to a year.

Miliaria sounds very similar to milia, but they should not be confused with one another. The former is also called heat rash or prickly heat because it occurs when sweat becomes trapped under the skin, causing irritation that leads to itchy, prickly skin (via Medical News Today). Similar to milia, anyone can experience miliaria, but babies are particularly prone to this due to their underdeveloped sweat ducts.

There are three different types of miliaria, categorized based on severity. According to a 2022 article published via StatPearls, miliaria crystallina develops on the superficial layer of the skin. They easily rupture, and look like water droplets without any signs of inflammation. They can be seen in babies usually less than 2 weeks old, and may appear on the upper trunk, head, and neck. They typically clear quickly, often within one day. On the other hand, miliaria rubra (the most common type) involves deeper skin layers and can show signs of inflammation. They are tiny, red bumps that can sometimes become infected and fill with pus (miliaria pustulosa). They are usually seen in babies between 1 to 3 weeks old, and may appear on the neck, armpits, and groin. Lastly, miliaria profunda involves even deeper layers of the skin and can be seen as skin-colored bumps. They are not typically seen in babies. Similar to baby acne and milia, miliaria usually clear spontaneously without any treatment.

Baby acne may possibly be linked to an infection with Malassezia, but other skin infections are not known to cause baby acne. Rather, the lesions seen in some skin infections may resemble and be confused with baby acne.

Hand, foot, and mouth disease (HFMD) presents with red blisters on the hand, foot, and mouth (per Healthline). It is commonly seen in children below age 5. Unlike baby acne, the lesions are often accompanied by other symptoms such as fever, drooling, irritability, decreased appetite, and headache. No treatment is necessary as the viral infection resolves within 7 to 10 days, but your baby's doctor may prescribe medicines that can help ease your child's symptoms.

Herpes, another viral infection, is rare in babies but can be very serious. Sometimes however, babies with neonatal herpes develop only cold sores around their mouth, which may be confused with acne (via Medical News Today). Similar to herpes in adults, it is a lifelong infection where lesions may come and go. Antiviral medications are used only to help treat cold sores, not to completely eradicate the infection.

Another skin infection that can resemble baby acne is scabies, caused by a mite that burrows into the skin. According to the Centers for Disease Control and Prevention (CDC), the itchy rash of scabies may resemble pimples and can develop on the face, neck, palms, and soles in infants. However, the rash is usually located elsewhere in adults and older children.

Cradle cap is the term used to refer to seborrheic dermatitis (dandruff) that forms on the scalp of babies (via Pampers). It causes flaky, greasy skin with yellowish crusting and an accompanying rash that may appear red, yellow, brown, purple, or gray. Cradle cap is not contagious and is usually not itchy nor painful. It typically resolves spontaneously within weeks or months, but in some cases, it may recur during puberty. This condition can be seen in babies between 2 weeks old to 12 months old. Aside from the scalp, it can also involve the face, back of the ears, neck, and armpits. 

Treatment for cradle cap is not usually necessary, but if your baby has it, there are several things you can do at home to help. According to Healthline, you should use gentle shampoo when washing your baby's hair and scalp, but you should avoid washing them too often, as this can dry out their skin. You can use baby oil to soften the crust that forms on your baby's scalp and brush it out gently with a soft hairbrush. Mayo Clinic adds that if these don't help, consult with your baby's doctor and ask them what products you can use. They may prescribe a medicated shampoo or cream. It is important to remember that you should never use over-the-counter products that are not recommended by your baby's doctor, as not all of them can be used on your little one.

Unlike children and adults, babies usually do not need to be bathed every day. Instead, two or three times a week should be more than enough. Of course, this does not include diaper changes and cleaning up after feeds, which should be done several times a day. According to the University of Rochester, you can give your baby a bath any time of the day. Initially, sponge baths are recommended, at least until your baby's umbilical stump has fallen off on its own. If you have a baby boy and had him circumcised, you should also wait until the wound has completely healed to prevent infection. After this, you can give your baby a tub bath.

During a sponge bath, make sure the room is warm without any wind drafts to avoid your baby getting cold. Use a clean, soft, moist washcloth and uncover your baby only one area at a time. You can use a small amount of baby soap for their body and wash their head last with shampoo. Once you are done, wrap your baby in a warm towel. The same principles apply when you give your baby a tub bath. Make sure to use warm water and never leave your baby alone. When it comes to skincare products, avoid heavily scented products, even if they are marketed for babies. When washing their clothes or bedding, only use baby laundry detergents that are free from fragrances and dyes (via WebMD).