When my first daughter was two weeks old, two spots appeared on her cheek the night before our newborn photos. I was panicking and despairing about these blemishes at the time, not knowing what they were, how to treat them, or how long they would last. I even took her back to the pediatrician to have her skin checked. As it turned out, these spots were a very common skin condition in newborns – baby acne. Little did I know that these spots would get worse and multiply over the next few weeks before finally disappearing.
If your baby’s perfect skin suddenly looks not so perfect, you may be, like me, worried and concerned. But learning what baby acne is and what it looks like—as well as the different types, causes, and treatment options—can help you feel reassured and empowered.
Newborn skin is precious and sensitive and is just learning to adapt to the outside world. Baby acne is one of many common and benign skin conditions in newborns, such as eczemaErythema toxicoma (a common rash in newborns) and milia.1 It occurs when pimple-like blemishes form on the head, face, neck and torso of a newborn.2.3 It is quite common and affects about 20% of all newborns.4
This type of acne can look very similar to the acne that occurs in teenagers. However, the cause of acne in teenagers and adults is usually bacterial. This is not usually the cause of acne in babies.2 Baby acne can appear as pimples or blackheads on your baby’s head, face, neck, chest, and upper back.2.4 The skin around the small blackheads can be red – my two daughters’ whole faces looked like they had a rash.
There are several main types of rashes that can occur in infants. They are differentiated according to their age of onset, appearance, severity and cause:
Neonatal acne is the most common form of baby acne. It is sometimes present at birth or can appear anytime within the first six weeks of life. It is slightly more common in male babies.3.4 Newborn acne looks like small, closed blackheads on the forehead, nose and cheeks.4 These blackheads can also appear on the scalp, chin, neck, chest and back and they can be red.3
Infantile acne occurs later than newborn acne and occurs after the 2nd month of life. The typical onset of infantile acne is between the 6th and 16th month of life, with an average of 9 months.3 Infant acne is similar to newborn acne in that it mainly affects the baby’s face and is more common in boys.4 But unlike newborn acne, infant acne can also be cystic and potentially leave scars.4 Infantile acne can also take longer to heal, usually six to twelve months.3
The third type is defined by its cause: Some acne can occur in babies when oils or ointments are applied to the face and cause a breakout. This type of acne would be diagnosed by removing ointments, oils and care products from the baby’s skin care routine and observing whether the acne disappears.4 This can also be confused with eczemawhich usually looks different than acne but should be considered a common cause of rashes.
Some people wonder if kissing can cause baby acne, but that is unlikely.7.8 Hormones are considered to be the main cause of acne in babies. Maternal and newborn hormones around birth can cause increased activity of the sebaceous glands in the skin.4
Newborn acne can last between one and four months, but usually disappears by 6 weeks of age. It requires no intervention and leaves no permanent marks or scars.1.4 Infantile acne can last longer and usually goes away on its own within six to twelve months after it appears.3 In severe cases, treatment may be necessary. If your baby develops acne after the second month of life, you should have him or her examined by your pediatrician.
Although baby acne usually goes away on its own over time without treatment, certain steps can help you manage your baby’s acne in the meantime:
Wash the baby’s face with a clean, lukewarm (not too hot!) washcloth.3 Use only gentle, unscented baby cleanser or just water.5.6 If you suspect that your baby’s rashes are caused by the shampoo, shower gel or another product, try changing the product or avoiding it altogether and washing the baby with only water to see if the problem goes away.3
Do not use acne medication on your baby’s face unless specifically directed by your doctor.3 If your baby’s acne is severe, bothersome and long-lasting, there are some ointments your pediatrician may be able to prescribe. They may also run tests for other causes or refer you to a pediatric dermatologist.
Avoid oils and greasy products
Some topical oils and ointments can cause or worsen the problem because they can clog pores and irritate blackheads.4 If you are currently moisturizing your baby’s skin with an oily or greasy product, stop using it and see if the acne improves.3
Acne lesions in babies usually go away on their own without leaving scars. It may be tempting to “pop” your baby’s blemishes, but being too rough can cause further irritation and possibly scarring.3
Although it can be upsetting to see your baby’s perfect skin irritated or blemished, baby acne in newborns is a common and temporary condition. Usually, the longer you leave it alone, the better. If you are concerned about a skin condition your baby has or would like a professional to take a second look, your baby’s doctor will be happy to do so. My children’s pediatrician always assured me that baby acne bothered me more than my baby, and reassured me that it caused them no discomfort. I am happy to report that now, at ages 3 and 1, neither of my daughters have any more acne or scars!
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