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Is It a Rash or Baby Acne?

Julie Nyhus FNP-BC is a Family Nurse Practitioner who writes about health and wellness.

Discovering your infant has a rash can cause panic. What is it? Do you need to call a doctor? Here are four of the most common rashes.

Discovering your infant has a rash can cause panic. What is it? Do you need to call a doctor? Here are four of the most common rashes.

Differences Between Baby Skin and Adult Skin

Baby skin is different from adult skin in several ways.

  • The layers of infant skin are about 30% thinner than adult skin but have higher water content. This makes the skin prone to dryness because moisture can be absorbed and released quicker.
  • In addition, the sweat glands in infant skin are immature and less effective.

Your baby's skin is delicate and many factors can affect its condition. There are numerous types of newborn rashes, but here we will discuss four of the most common:

  1. Neonatal acne
  2. Milia
  3. Infant eczema
  4. Erythema toxicum

Which Rash Is It?

Additional information about each of these conditions is provided below.


Neonatal Acne

Forehead, temples, or cheeks

Red or white bumps surrounded by red, inflamed skin


Nose, cheeks, or chin


Baby Eczema

Cheeks, arms, legs, trunk

Red bumps and patches

Erythema Toxicum

Face, chest, or arms and legs

Red, tiny bumps or red blotches

Baby acne is harmless and temporary.

Baby acne is harmless and temporary.

1. Baby Acne

Neonatal acne (or baby acne) is a type of newborn rash that is common and temporary. It can happen soon after birth, usually within the first few weeks of life, and affects about 30% of newborns.

This rash typically appears on the forehead, temples, or cheeks as red or white bumps surrounded by red, inflamed skin.


Although doctors do not know the exact cause of neonatal acne, there are some accepted theories. The condition is thought to occur in response to maternal hormones, yeast living on the skin, or a reaction to certain formulas. However, we do know that exposure to rough fabrics or certain detergents can make it worse.

Keep in mind that certain medications, allergic reactions, or viral infections can look similar to baby acne by causing red pustules and inflammation. Always consult with your healthcare provider.


Treating neonatal acne requires that the affected areas be kept clean and dry.

  • Cleanse the area daily with mild soap and water.
  • Avoid scrubbing the affected areas.
  • Never use acne products as they could damage the tender skin.

Newborn acne is a temporary condition that causes no discomfort and leaves no scarring. It will disappear on its own in a few weeks.

What Is the Difference Between Infantile Acne and Neonatal Acne?

Neonatal acne should not be confused with infantile acne which is rare. Here's how to recognize the difference.

Infantile acne:

  • occurs between the ages of three months and one year (later than neonatal acne)
  • includes both pustules (whiteheads) and comedones (blackheads).
Milia is a common baby rash and often confused with baby acne.

Milia is a common baby rash and often confused with baby acne.

2. Milia

Milia are common and can be mistaken for baby acne since they also present on the face. What makes milia different than acne is that they appear as tiny white bumps on the nose, cheeks, or chin. There will be no redness.


Milia are caused by skin flakes trapped on the surface of the skin. Often, babies are born with milia, or they can begin to appear within hours or days after birth.


It is important to keep the affected areas clean and dry. Cleansing the area daily with mild soap and water is enough. Just like with baby acne, milia are temporary and don't cause discomfort or scarring.

Just like newborn acne, milia will disappear on its own in a few weeks.

Here are some things to avoid:

  • The use of lotions or creams for these types of rashes is not recommended by doctors.
  • Scrubbing the affected areas does not help and should never be done.
  • Acne products should never be used as they can damage a baby's tender skin.
  • Rubbing or pinching the bumps can worsen the condition and leave scars.
Baby eczema can range from mild to severe and should be treated by your pediatrician or dermatologist.

Baby eczema can range from mild to severe and should be treated by your pediatrician or dermatologist.

3. Eczema

You may be familiar with eczema, an inflammatory skin condition, that affects children, adults, and the elderly. But eczema can affect infants too.

Baby eczema is another common rash that can be confused with baby acne. It can initially present as red bumps just like newborn acne, however, with eczema, red patches will always appear on the skin as well.

The patches may ooze or crust over becoming a bit uncomfortable for your baby. In addition, the skin can appear rough and be itchy. Your baby's pediatrician or dermatologist can help you determine the best treatment for this.

While baby eczema can affect only the face at times, leaving both cheeks with red bumps and red patches, for some babies, it can become very diffuse, affecting the whole body. Arms, legs, trunk, and the backs of hands and feet can all be affected.


Infant eczema can result from irritating substances like perfumes, lotions, or bubble baths but most cases do not have a known cause. It usually shows up between one and five months of age.


Some babies will outgrow infant eczema, while others will continue to experience issues. It can become troublesome if it lingers and may require a visit to the pediatrician or dermatologist for steroid medication.

Based on research, doctors often recommend specific creams and/or treatments to avoid flares. The good news is that with consistent, gentle skin care, eczema will improve and flares can be controlled.

Erythema toxicum is benign and fleeting.

Erythema toxicum is benign and fleeting.

4. Erythema Toxicum

Erythema toxicum is another common baby rash that can appear as red, tiny bumps or red blotches. The lesions often begin as small macules (flat, small spots) or papules (small, solid bumps). They range in size from one to four mm and progress to pustules (pimple-like bumps). The surrounding skin is red, thus the term "erythema".

This harmless condition often appears within the first days of birth, or sometimes within the first few hours of birth. Erythema toxicum can appear on the face, chest, arms or legs—sparing the palms or soles.


The cause remains unknown. Some medical experts think this condition could be a combination of the immature sebaceous glands and hair follicles in the baby's skin and microbes within the hair follicles.


Erythema toxicum is self-limiting, disappearing within 5-14 days after showing up. Keeping the skin clean and dry and avoiding lotions is the best treatment. Also, never pick or squeeze the pustules and always contact your baby's pediatrician if you have questions or concerns.


This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2019 Julie Nyhus FNP-BC