My Newborn Has a Rash. Should I Worry?

Newborn babies very commonly develop a number of skin conditions, most of which are quite benign, but nonetheless can be worrisome for new parents. Here are a few of the most common.

*For images of each condition, click on the highlighted links.

Erythema Toxicum: With a name like that, this rash sounds like something we should be worried about, but really it’s not. Typically developing around 3-4 days of life, these scattered red spots (which may look like pustules) may be present over the face, trunk, and extremities. They will resolve on their own over the first few weeks of life. No treatment is necessary. Erythema toxicum is not contagious.

-Transient Neonatal Pustular Melanosis: Much like erythema toxicum, this is a rash of unknown cause that occasionally is seen in newborns. Lesions look like very small pus-filled bumps. They may rupture and leave a scaly remnant. Typically, areas involved include face, neck, back, and shins. These lesions usually resolve on their own within 1-2 days and the residual dark, scaly marks will disappear over the following weeks. The rash is not contagious and there is no treatment needed.

-Milia: These tiny white or yellow papules (bumps) appear on the cheeks, chin, and nose of 40-50% of newborns. These usually disappear on their own in the first 3-4 weeks of life. No treatment is necessary and this rash is not contagious.

baby acne

neonatal acne

Baby acne: Around 3-4 weeks of age, some infants develop pimples (mainly on the face) that looks much like acne seen in teenagers. Although distressing to parents, this rash is not dangerous or contagious. Usually, the only treatment necessary is gentle washing with warm water daily. The rash with gradually resolve by 6 months of age.

Seborrheic dermatitis (cradle cap): This condition usually starts with greasy, scaly, red, and sometimes weepy lesions on the scalp, where it is known as cradle cap. It can spread over the forehead, ears, and eyebrows. This rash usually appears during the first two months of life. It does not seem to bother infants, and most cases resolve spontaneously by 8-12 months of age. If desired, parents may apply mineral or baby oil, gently massage scalp with soft toothbrush, and then wash with baby shampoo.

Not all infant rashes are innocent. Red flags for seeking care: If your newborn baby has a rash that looks like chicken pox (varicella) or herpes they need to be seen urgently. If your young infant has fever associated with their rash,¬†is not feeding well, does not have as many wet diapers as usual, or is otherwise acting ill, these are definitely reasons to see your child’s health care provider.

This is the first in a series on skin conditions in young children. Upcoming posts will focus on diaper rash and atopic dermatitis (eczema).

4 thoughts on “My Newborn Has a Rash. Should I Worry?

    • However, newborns shouldn’t be getting vaccines (other than Hep B, which certainly doesn’t cause rashes), so not applicable to this article.

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