Does Your Baby Have Acne? Here’s What to Look For (With Images)

Not all newborn babies have a flawless complexion. In fact, new babies can have a whole range of skin changes that are completely normal. The good news? They usually go away on their own.

Acne is a common skin problem among babies, and it can start as early as birth. There are a couple of types of baby acne, according to Adnan Mir, MD, PhD, a clinical assistant professor at Albert Einstein College of Medicine and member of the Society of Pediatric Dermatology. They may look slightly different and have different causes, but both types of acne usually go away on their own without needing treatment.

Types of baby acne

There are two types of baby acne — neonatal acne and infantile acne. They differ in their causes, when they start, and how long they last. 

“Neonatal acne (known as neonatal cephalic pustulosis) is much more common and usually appears at or soon after birth,” says Dr. Mir. And it usually goes away on its own after a few weeks.

Infantile acne is less common. It usually shows up in infants between 6 weeks old and 12 months old. 

Keep in mind that some babies can have both types of acne at the same time. 

What causes baby acne?

The cause of baby acne depends on which type your baby has. Neonatal acne is caused by a reaction to Malassezia, a normal skin yeast that can show up in the first few weeks of a baby’s life. 

Infantile acne is different. “This type of acne is caused by maternal hormones circulating in the baby’s system,” Dr. Mir told us. It can go on for longer, although it typically resolves within the first year of life. 

What does baby acne look like?

Baby acne often affects the cheeks and nose, but it can also involve the forehead and chin, scalp, neck, chest, and back. 

At first glance, the different types of baby acne may look the same. But there are some key differences between the two types.

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Neonatal acne 

Neonatal acne usually starts like small bumps on the face and scalp. They may be pink or red (in fairer skin), or violet or brown (in darker skin). And some may contain pus. But there are no whiteheads or blackheads, according to Dr. Mir.

Infantile acne

Infantile acne looks more like the typical teenage acne. “You’ll see comedones (blackheads and whiteheads), red pimples, and sometimes small pus bumps,” Dr. Mir told us. In rare situations, infantile acne can be more severe and have cysts and nodules, which are larger and deeper in the skin.

Which rashes can be confused with baby acne?

Baby acne is usually pretty easy to identify. But sometimes it looks similar to other common baby rashes that also cause bumps and spots. 

Milia

Milia (often called “milk spots”) are tiny skin cysts that form smooth, white, or yellowish bumps. These spots are common on the nose, cheeks, and forehead. Unlike acne, they aren’t red or inflamed.

Sebaceous hyperplasia

These are oil (sebaceous) glands that become temporarily enlarged from maternal hormones. They show up as small, yellowish bumps, usually on the nose and cheeks.

Transient neonatal pustular melanosis

This rash is more common in Black newborns. It causes small, pus-filled bumps that can break easily and become scaly. When they do, they leave a small brown spot that eventually fades over 3 to 4 weeks. It can affect all areas of the body.

Erythema toxicum

Erythema toxicum causes tiny red or brown flat patches and bumps that eventually turn into pus-filled bumps surrounded by redness. In addition to the face, these are common on the torso, arms, and legs (but not the palms or soles). 

Unlike some of the other rashes, erythema toxicum usually starts a few days after birth and then goes away in 1 to 2 weeks.

Miliaria

Miliaria, or heat rash, is caused by blocked sweat glands. The rash can look like red or brown skin bumps or tiny blisters. It typically happens on the scalp or covered skin that gets hot and sweaty.

What to do for baby acne

Baby acne is a completely normal part of being a newborn. Both types of baby acne usually go away on their own without treatment and without leaving any scars or marks. For most babies, that means being free of acne within the year. 

But sometimes parents and caregivers can find it hard not to do anything. After all, isn’t a baby’s skin supposed to be flawless? 

The best way to care for your baby with neonatal acne is to take good care of their fragile skin. “A gentle cleanser at bathtime is usually enough,” said Dr. Mir. You can also incorporate these tips into your baby’s routine: 

• Avoid harsh soaps, scrubs, or alcohol-based astringents.

• Avoid thick moisturizers, as these can clog pores.  

• Clean your baby’s skin immediately with warm water after they eat or throw up.

• Don’t squeeze or pop pimples. This can lead to infection or scarring 

When to get professional help

If you’re worried, or the skin rash isn’t settling, talk with your pediatrician or primary care team. 

In rare cases, neonatal acne may be severe and involve a large amount of the face or skin. When this happens, your care team may recommend an antifungal cream like ketoconazole to help treat skin yeast. Severe infantile acne is more likely to leave scars. For severe acne, your pediatrician may recommend baby-safe acne treatments, according to Dr. Mir.

But don’t start any medicated creams or treatments without talking to your care team first.

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Written by:

Maria Robinson, MD, MBA

Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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