Women's Healthcare Topics

Baby Acne and Milia

Reviewed by James Brann, M.D.

Baby Acne Usually Appears at 3 Weeks of Age

Baby acne, or acne of the newborn, may worry you when you first spot it. After all, a newborn's skin is supposed to be smooth and clear. But if you spot pimples on baby's cheeks, forehead, chin, or even his or her back, don't be alarmed. Baby acne is very common – and temporary. It will go away without any medical treatment.

Roughly 20 percent of all newborn babies experience neonatal acne. Experts do not know what causes this type of baby acne. Researchers once thought that newborns developed baby acne because of stimulation of the baby's sebaceous glands (oil-producing glands on the skin) by lingering maternal hormones after delivery. The theory was that hormones from the mother crossed the placenta into the baby, and after delivery, these hormones cause the oil glands on the baby's skin to form bumps that look like pimples. Many researchers now doubt this theory.

Currently, experts and researchers in the field argue that baby acne may occur because of an inflammatory reaction to the yeast, Malassezia, on the skin. Hormonal fluctuations may also play a role in the development of baby acne.

When a newborn has baby acne, he or she has small red bumps or pustules on his or her cheeks, forehead, and chin. The acne will look worse when your baby is fussy or crying.

Traditionally, baby acne sets in at 3 weeks of age, though it may be present from the time of delivery. Male babies are more often affected than female babies

The most frequent types of acne in infants are papules and pustules. Papules are small, solid, rounded red bumps rising from the skin similar to a red pimple. Pustules or whiteheads are a small bump in the skin that has a collection of pus.

Most babies develop acne in and around the face, including the cheeks and sometimes on the scalp. Most lesions that develop will spontaneously resolve themselves within a four-month time frame, thus most newborn babies will not need treatment to clear up their acne. In many cases, baby acne disappears within several weeks.

This article is to help you care for baby acne, or acne of the newborn.

Baby Acne Treatment and Prevention

While there is nothing you can do to prevent baby acne, it can help to gently cleanse the face at least once a day with water and mild baby soap. Afterwards, you should pat your baby's skin dry. It's important that you do not pinch or scrub the baby acne. This is not an effective baby acne treatment. Instead, it may make your baby's acne worse. In addition, you may aggravate the condition with the use of oils or lotions. Oils and lotions that are so-called "treatments for baby acne" just do not help. Remember baby acne will disappear spontaneously in a few weeks.

Many first time parents worry that they won't be able to take pictures with their newborn until their acne clears up. Rest assured, parents have photographed their precious angels, acne or no acne. You can always get touch-ups if you feel concerned about it. Remember that neonatal acne or baby acne largely is a temporary condition that your newborn baby will outgrow in the first few months of life.

Sometimes when a baby presents with severe acne, you doctor may recommend you treat it with benzoyl peroxide, topical creams like retinoids or other keratolytic agents. Before trying any baby acne treatment, call your pediatrician to get his or her approval.

Interestingly, a family history of acne does not suggest your baby will develop acne after birth. Also, just because your baby develops acne after you give birth does not mean they will have severe acne as an adolescent or adult.

Newborn or baby acne is different from but often confused with two other conditions called "milia" and infantile acne that we will discuss in the next sections.

Baby Health Section


Babies who suffer from infant acne may also have Milia.

Milia, or miliaria acne, are the tiny white bumps that appear on a newborn's nose, cheeks, or chin. In some cases, milia can also appear on the upper trunk of the body, as well as your baby's arms and legs.

(The most distinct difference between baby acne and milia is the color of the bumps. Baby acne is characterized by small, red bumps; milia is characterized by tiny white bumps.)

Milia is rarely present at birth. Although this baby skin condition can develop at any age, it typically develops during the first week of life. Over 50 percent of all babies develop milia.

Milia is common in babies who are born in a warm climate. Milia is also associated with the warming of the baby by an incubator, occlusive dressings, clothing, or fever. This skin condition of newborns develops because tiny skin flakes and sweat gets trapped in the small pockets near the surface of the skin.

While you may be concerned about the sudden development of milia (remember that it typically develops when your baby is one week old), this infant skin condition will go away on its own. In most cases, milia will disappear within several weeks without any treatment.

Sometimes, milia will plague your baby for the first three months of life. In the event that your baby's milia looks severe or it does not go away after three months, your doctor will consider other diagnosis.

But luckily, this baby acne resolves rapidly and may improve with measures to reduce sweating, such as loose clothing and cool baths.

Infantile Acne

There are other types of acne that might develop over time, including infantile acne. Infantile acne refers to acne that develops three months of age or later. It is a separate condition from milia, newborn acne or baby acne, which occurs shortly after the baby's birth.

Typically infantile acne results from the presence of lingering maternal hormones, just as newborn acne or baby acne. Infantile acne is more severe than neonatal or baby acne. Typically babies with infantile acne develop yellow papules on the face, usually on the nose and cheeks. Other types of acne including comedones (blackheads and whiteheads) and pustules also develop.

The good news is this acne usually spontaneously disappears after about 12 months of age, though in some babies the condition may persist until your baby reaches the age of three. This largely is dependent on genetics. Just like during puberty, the level of testosterone in your child varies in part because of their genetic make up.

Like neonatal acne or baby acne and milia, usually no treatment is needed to help relieve infantile acne. For babies with severe acne, you can apply benzoyl peroxide or other topical agents occasionally to help relieve inflammation and swelling. When infantile acne is present, some children may have a recurrence of symptoms during the teen years at puberty.

Acne in the newborn is not usually a serious condition. Infantile acne, like newborn acne or baby acne and milia, often resolves itself during the first year or so of life. There are some situations, particularly later in life during the preteen and teen years when acne may result from a more serious infection. If you have more questions about acne or acne treatments, be sure to contact your healthcare provider for treatment alternatives and advice.


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