Neonatal acne, commonly called baby acne, is a common skin condition affecting many newborns shortly after birth. It typically appears as small red bumps or whiteheads across the cheeks, nose, and forehead. Although the appearance can be concerning for new parents, this condition is temporary and harmless. It usually clears up without needing medical treatment and does not leave scars.
The Role of Maternal Hormones
The primary cause of baby acne is the influence of hormones passed from the mother to the baby while in the womb. A surge of maternal hormones, particularly androgens, transfers to the infant across the placenta during late pregnancy. These residual hormones remain in the newborn’s system for a period after delivery.
These androgens act on the baby’s sebaceous glands, which produce oil, or sebum. The hormonal stimulation causes these glands to enlarge and produce excess sebum. This overproduction clogs the hair follicles, leading to the inflammation and breakouts characteristic of acne.
This hormonal activity explains why neonatal acne typically emerges around the second to fourth week of life, as the hormones clear from the baby’s body. It is a natural physiological process, not caused by the baby’s diet, poor hygiene, or external irritants. The acne gradually resolves as hormone levels decrease and the baby’s system stabilizes.
Distinguishing Baby Acne from Other Skin Conditions
Parents frequently mistake baby acne for other common rashes, so correct identification is helpful. True neonatal acne presents as small red papules and pustules on the face, specifically the cheeks and forehead. It is differentiated by its appearance as pimples that may have a reddish base.
Milia are tiny white or yellow bumps often found on the nose and cheeks, but they are not inflammatory. Milia are caused by blocked keratin trapped under the skin, lacking the surrounding redness of acne. Erythema toxicum neonatorum appears as blotchy red patches with small yellowish-white bumps in the center, mainly on the trunk and limbs.
It is important to distinguish neonatal acne from infantile acne, a rarer and more severe form. Infantile acne appears later, typically after three to six months of age, and can include deeper lesions like blackheads and cysts. If the rash persists or seems severe, it may be infantile acne and requires a different approach.
Gentle Care and Management
Since baby acne is a temporary, hormone-driven condition, the best management involves minimal intervention. The recommended approach is to gently wash the affected areas once a day with plain warm water or a mild, non-soap cleanser. The skin should be patted completely dry with a soft towel, rather than rubbed, to avoid irritation.
Parents should avoid squeezing or picking at the bumps, as this can introduce bacteria, worsen inflammation, and potentially lead to infection. Do not use adult acne treatments, such as products containing benzoyl peroxide or salicylic acid, because they are too harsh for a baby’s delicate skin. Applying heavy oils, lotions, or greasy ointments should also be avoided as they can clog pores further and aggravate the condition.
The acne usually resolves completely on its own within a few weeks to a couple of months as the maternal hormones clear the baby’s system. If the acne is severe, appears painful or infected, or persists beyond three months of age, a consultation with a pediatrician is necessary. Medical professionals may prescribe a mild topical medication in these specific instances.