Different types of baby acne and how to help manage them

Little ears, a sweet button nose and pea-sized toes. What’s more adorable than a tiny newborn? But what new parents might not expect are a few surprise visitors: miniature acne spots on a baby’s face.

While we often associate breakouts with adolescence, about 1 in 5 babies will get neonatal acne before they’re 6 weeks old. In fact, some infants develop acne while still in the womb. The acne can be present on their back, chest and face, or on their scalp or neck. Here are some important things to know about this common condition. 

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What can cause baby acne?

Baby acne and teenage acne aren’t exactly the same thing. In older children and adults, acne crops up when pores become obstructed. Hormones play a role by stimulating the oil glands that can cause those obstructions to happen. A. Yasmine Kirkorian, MD, chief of dermatology at Children’s National Hospital, says, “What we call ‘baby acne,’ health care providers call neonatal cephalic pustulosis.”

In babies older than 6 weeks, infantile acne can develop. This is much less common, and found in fewer than 2 percent of babies. Unlike neonatal cephalic pustulosis, infantile acne is believed to be related to hormones and increased oil production. It can also leave scars on the skin.

What does baby acne look like?

Neonatal acne, which appears before a child is 6 weeks old, looks like small red bumps. They often show up on the chin, forehead and nose but can also appear on the back, chest, neck and scalp.

Infantile acne, which appears after the 6-week mark, looks similar and is typically found on the back, chest and face. New parents may also see bumps that look more like pustules or cysts.

Ways to help manage baby acne 

Dermatologists agree that acne on babies under 6 weeks old will often go away on its own. Be sure to avoid acne medications or creams intended for older children and adults unless it’s recommended by the child’s pediatrician or dermatologist. Harsh medications can cause further irritation.

Lauren Ploch, MD, MEd, a dermatologist in Augusta, GA, and Aiken, SC, notes that in rare cases, a dermatologist may have tests done and prescribe topical medications. In most instances, choosing mild soaps may help care for a baby's skin. “Look for the mildest ingredients and avoid things that could irritate the skin or cause allergic reactions,” says Dr. Ploch.

Bathe babies using lukewarm (not hot) water and avoid scrubbing any areas where acne occurs.

Fragrance-free washes include CeraVe Baby wash and shampoo and Aveeno Baby cleansing therapy moisturizing wash. Fragrance-free moisturizer options include Vanicream moisturizing skin cream for sensitive skin and CeraVe Baby moisturizing lotion.

“Vanicream and CeraVe Baby are my favorite brands to recommend,” says Dr. Ploch.

If a baby develops acne at 6 weeks or older, it’s a good idea to see a board-certified or pediatric dermatologist. These health care providers can help ensure that it’s actually acne and check for any underlying issue. A dermatologist can also give advice to help prevent skin scarring and recommend medication if it’s needed.

Is this baby acne or something else?

Babies may suffer from a number of different mild rashes and skin conditions other than baby acne. Common skin issues can include the following:

• Cradle cap. Also known as seborrheic dermatitis, cradle cap is a crusty rash that forms on a baby’s head, which can be yellow, thick and scaly, and is caused by a buildup of oil and dead skin.
• Eczema. Baby eczema could be caused by dry and sensitive skin (sometimes allergy related) and looks like patches that are itchy, red and scaly.
• Heat rash. This kind of rash develops as small red or pink spots on skin that’s prone to overheating, like the armpits, diaper area and neck.
• Milia. This skin condition presents as tiny white bumps that can appear on the face or nose, due to oil glands being blocked.

“Rarely, there can be other serious rashes that babies can get, so any unusual or worsening rash in a newborn should be evaluated by a pediatrician or board-certified dermatologist,” says Dr. Kirkorian.

Baby skin care

Most newborns don’t need an extensive, multistep skin care routine. But using products specific to babies is key, explains Dr. Kirkorian, because “babies have very sensitive skin.” Look for products designed for newborns. “Over-the-counter (OTC) baby care lines are meant for baby skin and have products that are safe to use,” she says.

It is recommended that caregivers bathe babies only two to three times per week while keeping the diaper area as clean and dry as possible throughout the day and night. In between washes, baby wipes can be used to help clean up any poopy messes from diapers.

However, in situations where wipes aren’t available, options such as a damp tissue, a quick bath or washcloths and water can serve as acceptable alternatives.

Examples of baby cleansers include CeraVe Baby wash and shampoo, Eucerin Baby wash and shampoo and The Honest Company sensitive fragrance-free shampoo and body wash. Baby wipes to consider include Pampers sensitive baby wipes and Huggies Natural Care baby wipes.

Remember that skin issues in newborns and babies are possible. However, if anything concerning appears, caregivers can make an appointment with a health care provider to help ensure that their baby stays happy, healthy and free of discomfort.