When my first daughter was 2 weeks old, two blemishes appeared on her cheek the night before our newborn photos. At the time, I panicked and was distraught over these imperfections, as I didn’t know what they were, how to treat them, or how long they would last. I even took her for an extra visit to the pediatrician to have her skin examined. As it turns out, these pimples were a very common newborn skin condition — baby acne. Little did I know that these spots would worsen and multiply over the next few weeks before eventually resolving.
When your baby’s perfect skin suddenly appears not-so-perfect, you may feel alarmed and concerned like I did. However, learning what baby acne is and what it looks like — as well as the different types, causes, and treatments — can help you feel reassured and empowered.
Newborn skin is precious and sensitive, just learning to adjust to the outside world. Baby acne is one of many common and benign newborn skin conditions, like eczema, erythema toxicom (a common newborn rash), and milia.1 It occurs when pimple-like blemishes form on a newborn’s head, face, neck, and trunk.2,3 It’s quite common, with around 20% of all newborns developing it.4
This type of acne can look very similar to the acne that occurs in teenagers. However, the cause of teen and adult acne is usually bacterial. This isn’t usually the cause of acne in babies.2 Baby acne may look like bumpy pimples or whiteheads on your baby’s head, face, neck, chest, and upper back.2,4 The areas of skin surrounding the little whiteheads may be reddened — in both of my daughters’ cases, their whole faces looked like they’d broken out in a rash.
There are a few main types of rashes that can develop in infants, and they’re differentiated by their age of onset, appearance, severity, and cause:
Neonatal acne is the most common type of baby acne. It’s sometimes present at birth or can appear at any time within the first six weeks of life. It’s slightly more common in male babies.3,4 Neonatal acne looks like small, closed whiteheads on the forehead, nose, and cheeks.4 These whiteheads can also appear on the scalp, chin, neck, chest, and back, and they may be red.3
Infantile acne emerges later than neonatal acne, appearing after 2 months of age. The typical onset of infantile acne is between 6 and 16 months of age, with a median of 9 months of age.3 Infantile acne is similar to neonatal acne in that it mainly affects a baby’s face and is more common in boys.4 But unlike neonatal acne, infantile acne can also appear cystic and has the potential to leave scars.4 Infantile acne can take longer to clear up as well, usually resolving in six to 12 months.3
The third type is defined by its cause: some acne can happen in babies when oils or ointments are applied to the face and cause a breakout. This type of acne would be diagnosed by eliminating ointments, oils, and care products from baby’s skincare routine and seeing whether their acne clears up.4 This may also be confused with eczema, which typically looks different than acne but should be considered a common cause of rashes.
While some wonder if kisses can cause baby acne, it’s unlikely that they will.7,8 Hormones are presumed to be the main cause of acne in babies. Maternal and neonatal hormones around the time of birth can cause an increase in the activity of oil-secreting glands in the skin.4
Neonatal acne can last anywhere from one to four months but typically resolves by 6 weeks of age. It requires no intervention and won’t cause permanent marks or scarring.1,4 Infantile acne can last longer and typically resolves on its own between six and 12 months after onset.3 In severe cases, it may require treatment. If your baby has acne that starts after 2 months of age, you should have your pediatrician see them.
Although baby acne usually clears up on its own in time without treatment, certain interventions can help you manage your baby’s acne in the meantime:
Wash baby’s face with a clean, lukewarm (not too hot!) washcloth.3 Use only gentle, unscented baby cleanser or just plain water.5,6 If you suspect your baby’s shampoo, body wash, or other product is causing their breakouts, try changing products or eliminating them altogether and washing with just water to see if it clears up.3
Don’t use any acne medication on baby’s face unless a doctor specifically instructs you to do so.3 If your baby’s acne is severe, bothersome, and lasting, there are some ointments that your pediatrician may consider for a prescription. They may also do testing for other causes or provide a referral to a pediatric dermatologist.
Avoid Oils and Greasy Products
Some topical oils and ointments can cause or worsen the issue because they can clog pores and irritate whiteheads.4 If you’re currently moisturizing your baby’s skin with an oily or greasy product, discontinue this and see if their acne improves.3
Baby acne lesions will typically resolve on their own without leaving a scar. It can be tempting to try to “pop” your baby’s blemishes, but being too rough on them can cause further irritation and potential scarring.3
While it can be distressing to see your baby’s perfect skin look irritated or blemished, baby acne is a common and temporary condition in newborns. Typically, the more you leave it alone, the better it will be. If you’re concerned about a skin condition in your baby or want a professional to take a second look at it, your baby’s doctor should be more than happy to do so. My children’s pediatrician always assured me that baby acne bothered me more than my baby, giving me comfort that it wasn’t causing them any discomfort. I am happy to report that now, at the ages of 3 and 1, neither of my daughters has any lingering acne or scarring!