Baby acne: symptoms, signs and treatment

Medically reviewed Dr Juliet McGrattan (MBChB), words Annie Hayes
Photo credit: Tatyana Tomsickova Photography - Getty Images

From Netdoctor

Baby acne is a common skin condition that can develop on a baby’s face or body. Also known as neonatal acne or Erythema Toxicum Neonatorum (ETN), it affects around 20 per cent of newborn babies and only occurs in the first few months of life.

Generally, baby acne emerges around two weeks after birth, but it can develop any time before the baby reaches six weeks of age. Occasionally, a baby may even be born with baby acne. Despite the name, baby acne is actually a rash.

We asked medical experts and dermatologists to explain what baby acne looks like, discuss related conditions and share at-home treatment advice.

What is baby acne?

Baby acne is a common skin rash that affects healthy newborn babies, and it presents in tiny red or white bumps or pimples.

Unfortunately, the terms ‘baby acne’ and ‘ETN’ make the condition sound far more serious than it actually is. In reality, it’s nothing to worry about and very simple to treat. ‘Baby acne is not the same as acne vulgaris, which affects adults and teenagers,’ says Dr Ross Perry, medical director at Cosmedics. ‘The condition is not toxic or dangerous, as it suggests in the ETN terminology.’

Baby acne causes

It is unclear why baby acne develops. However, it is believed to be caused by maternal or infant hormones, explains Dr Lucy Glancey of the Dr Glancey Clinics.

Baby acne symptoms

Baby acne is a raised rash with small pus-filled spots, ‘hence the reference to acne’, says Dr Perry. The red spots blanch on pressure, meaning they disappear or turn white.

The condition can affect the baby’s face or body, including the chest, scalp, arms and hands. ‘Baby acne is most common on the cheeks, but it can also appear on their backs or neck,’ Dr Glancey explains. ‘It may look disturbing but it is not usually cause for concern.’

What does baby acne look like?

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How long does baby acne last?

It’s also important to note that baby acne differs from infantile acne, which can develop after six weeks of age, although typically between three and six months. While nowhere near as common, infantile acne tends to last far longer than baby acne.

Infantile acne is incredibly rare, however it is something that can develop in babies and children,’ says Dr Daron Seukeran, consultant dermatologist at skin. ‘However, it is a recognised condition and can be treated successfully. After 12 months, it will usually settle and will usually resolve itself.’

Baby acne treatments

Baby acne usually disappears on its own within a few weeks or months, without the need for treatments. But there are some steps you can take to make the recovery process quicker and more comfortable for your baby.

Dr Perry recommends avoiding over-washing the baby as babies have delicate skin that can dry out easily. ‘Resist any temptation to pick, squeeze or burst any pus-filled spots. This makes a skin infection more likely to occur,’ he adds.

Do not use over-the-counter acne treatments, such as face washes and serums, as these products will only make the condition worse. It’s not advisable to use products designed for adult acne as they are too strong for the delicate baby skin and will cause irritation,’ adds Dr Glancey.

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If you use products to wash and moisturise your baby, make sure they are fragrance-free and specifically designed for babies. Creams and lotions are not required to treat the rash, but your doctor may prescribe a medicated ointment if the acne has not cleared within several months of home care.

If acne in young children is persistent, a topical treatment such as benzoyl peroxide or topical retinoids will be used to help, and oral antibiotics can be used for those with more severe acne,’ says Dr Seukeran. ‘If severe or persistent, further investigations by a paediatrician or dermatologist would be undertaken.’

What conditions may resemble baby acne?

Baby acne is not the only skin condition that may cause this kind of rash. There are a few others to be mindful of. ‘Eczema is probably the most similar, as small red bumps or patches can be seen in both conditions,’ says Dr Glancey.

The key difference between baby acne and eczema ‘is that eczema is more of an inflammatory skin condition and is not always associated with infection’, Dr Perry explains. ‘Those raised white little pus-filled spots which are characteristic of baby acne do not occur in eczema,’ he says. ‘Baby skin that tends to have eczema will generally be dry and flaky and also red, but lacks the pustules that are seen in baby acne.’

Inflammation of the hair follicles, a common skin condition known as folliculitis, may also resemble baby acne. Milia sometimes looks similar – caused by skin flakes or a protein called keratin becoming trapped under the skin, it presents as white pimples without the red patches.

It’s always best to seek professional advice if you have any concerns about your baby’s skin. ‘Any rash on a baby should be taken seriously’, says Dr Perry. ‘If there’s any doubt as to the cause of a skin rash, it’s essential that you seek medical advice and a firm diagnosis. This is especially important if your baby seems unwell in any way.’

Last updated: 09-06-2020

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