5 Newborn Rashes Demystified
Newborn babies can have several interesting bumps and rashes on their skin that look scary to parents, but are completely harmless. Below, I will describe five of the most common newborn rashes that I see in babies. I include a picture of each below, because when it comes to skin, a picture really is worth a thousand words. It can be difficult for families to tell the difference between some of these, as they can look similar. If you are worried, reach out to your Pediatrician and we can take a look!
Erythema Toxicum
The name of this newborn rash is really unfortunate. The word “toxicum” sounds like it is a condition that is toxic and dangerous. On the contrary, this rash is very common and not harmful at all. This rash usually starts within 3 days after birth. It first appears as scattered pink/red flat or slightly raised spots on the baby’s skin. Then a raised pustule develops in the middle of the red spots. The rash is most common on the abdomen, chest, and back, but can also be on the arms and legs.
We don’t quite know what causes this rash. However, we do know that it goes away on its own in about a week without treatment. Erythema toxicum does not cause pain or any other symptoms. The babies continue to act normally. They do not develop fever or any other symptoms.
Milia
Milia are very common in newborns but can also be found in people of all ages. They are small white bumps, often seen on the nose, cheeks, and underneath the eyes. The bumps are painless and are not itchy. They are caused by trapped keratin in the hair follicles. Many babies are born with milia. These go away on their own, usually after a few months, as the keratin gradually works its way out of the follicles. Milia are not dangerous and there is no treatment needed.
Sebaceous Hyperplasia
These are also very common in newborn babies. About half of newborns will have this newborn skin finding. It appears as tiny (1-2mm) smooth white/yellow bumps, usually on the bridge of the nose. In the womb, babies are exposed to certain hormones which make their sebaceous glands very active. This is actually what helps to produce the protective white covering on a newborn baby’s skin, called the vernix. After the baby is born and no longer exposed to those specific hormones, the white/yellow bumps resolve gradually over the next few weeks. They are not dangerous, do not cause any symptoms, and do not require treatment.
Miliaria
This is more commonly known as “heat rash.”. It appears as tiny white/red/clear dots on the skin. This newborn skin finding is caused by blockage of the sweat ducts in the skin and is more common in hot/humid environments. However, newborns have sensitive skin and ducts that can clog easily, so sometimes they develop miliaria even if they haven’t been in the heat for very long. This rash does not cause pain or any other symptoms. It often starts to look better once the baby has been back in a cool environment for a few hours. The rash resolves quickly without any treatment.
Newborn Acne
Babies can develop acne, kind of like teenagers! Newborn acne usually starts when the baby is 2-3 weeks old. This newborn rash looks like tiny pimples, red or white, scattered on baby’s face and sometimes on their scalp, neck, and upper chest. Some babies get just a few pimples, while other babies can develop several hundred. This newborn skin finding is caused by hormonal changes and a certain bacteria on the skin. The acne hits a peak and looks the worst at about 4-5 weeks old. Then it gradually fades out by around 2 months of age. There is no medication that can make the acne go away faster. However, washing the affected area daily with water and fragrance free soap and avoiding scented products (detergent, lotion, etc) will help decrease the inflammation.
