If you’re wondering how to get rid of baby acne, you are not alone.
In this article, we’ll go through the different types of baby acne, what’s causing them, how to treat baby acne, what not to do, and also what other skin conditions may mimic baby acne.
Skin problems are one of many concerns parents may have about their newborn baby. They worry whether or not there will be skin sensitivities, dryness, or rashes.
Just when the routine of feeding, sleeping, and diaper changes has been established, “red spots” begin to develop on the baby’s cheeks. Instead of fading within a few days, they spread and start to resemble acne. This can be very worrisome for parents, conjuring up images of adolescents with cystic acne and scarring.
Fortunately, the majority of infants do not experience a level of severity. Most baby acne is a very different entity.
All About Baby Acne and How to Treat It
The Definition of Acne
Acne is an inflammatory skin condition characterized by lesions called comedones. There are two forms of comedones: open and closed. Open comedones are more commonly referred to as “blackheads.” The clogged central pore turns dark in color due to air exposure. In contrast, closed comedones have a red base with a raised center that looks like pus. This version is most commonly seen in infants.
Types of Baby Acne
This form of baby acne develops around the second week of life and self-resolves no later than four months old. 20% percent of infants experience neonatal acne, and it is more common in males.
It is typically found on the cheeks and nose, but may also appear on the forehead, chin, chest, and back.
Unlike the acne of older infants and children, this type is caused by a neonate’s immature immune response to the fungus, Malassezia species (source). This fungus is part of the normal skin flora, not an infection.
Coincidentally, Malassezia species also causes infantile seborrhea or “cradle cap.”
When acne develops in a three to 12-month-old, the infantile form is more likely. Closed comedones appear on the same body locations as the neonatal type, but cysts and skin nodules may be present.
Upon resolution, they leave scars on the affected areas.
Two percent of infants develop infantile acne, and it is likely to re-occur during adolescence. The most common causes are hormonal problems or skin exposure to an offending product.
What Mimics Baby Acne?
There are a variety of neonatal rashes that may be confused with baby acne.
Many infants are born with small white or yellow “bumps” on their noses, chins, or cheeks. These are not comedones, but cysts filled with keratin and called milia.
They self-resolve over the first few weeks or months of life, leaving no permanent marks on the skin.
The absence of surrounding redness or inflammation helps to distinguish milia from baby acne.
No treatment is needed or helpful, and nothing can be done to prevent milia. It is just one of those skin conditions often that appear in newborns.
This condition is commonly known as “heat rash.” When a baby is exposed to temperatures that are too warm, excessive sweating results in obstruction of the sweat glands, forming red “bumps”. These may appear on the forehead, chest, and back.
In most cases, the rash responds to cooling measures, then resolves within a few days. It is possible, however, for persistent miliaria to become infected with bacteria, and require the use of an antibacterial wash for bathing.
This rash differs from baby acne because it is triggered by overheating.
Despite its horrible-sounding name, this is a normal newborn rash. Approximately 50% of all newborns will experience the condition.
The lesions resemble mosquito bites, having a raised center that is surrounded by a red base.
They begin on one or two body locations by the third day of life, then spread head to toe. Unlike baby acne, erythema toxicum resolves within a week or at least within 2 weeks.
Although erythema toxicum is completely harmless, it is common for parents to be worried when it appears. The cause is unknown, but thought to be related to the immune system.
Transient Neonatal Pustular Melanosis
This rash consists of clear, fluid-filled blisters on the forehead, chin, torso, and buttocks. Most often, they are seen at birth, and in infants with higher skin pigmentation.
The condition is relatively rare – some 1% of newborns worldwide are affected. However, it is more common among black, with an incidence of 4.4%.
The blisters resolve within two days but may cause residual skin darkening that can last for months.
This rash is benign and self-resolves. As with several other neonatal skin conditions, the cause is unknown.
There is no need for treatment.
Most infectious rashes are associated with other symptoms of illness. These may include fever, irritability, poor feeding, and difficulty sleeping. Instead of comedones, blisters, pustules, purpura, or simple red papules are present. In addition, it is more common for the rash to affect extensive areas of the body.
Examples include viral infections such as coxsackie and measles, and bacterial impetigo or meningitis. Infections in infants under the age of three months can be very serious, and require emergent medical attention.
How to Get Rid of Baby Acne
What NOT To Do
Because neonatal acne self-resolves with no residual effects, treatment is unnecessary. Parents and caregivers may be tempted to squeeze the comedones or to apply acne products, but neither remedy is recommended.
Even for cases of infantile acne, it is best to avoid aggressive attempts to clean the affected skin areas. This may increase irritation. Due to the possibility of permanent scarring, treatment may be recommended. Acne medications, however, have not been clinically tested in infants, and should not be used unless advised by a doctor.
What TO Do
For any rash that fails to resolve within a few days, it is best to seek help from your healthcare provider. He or she can confirm the diagnosis, and distinguish baby acne from other medical conditions. This avoids treatment errors and exacerbation of symptoms.
Treating Neonatal Acne
If the issue is solely neonatal acne, keeping the area clean with warm water and a mild soap is all that is required. Oily emollients and moisturizers may worsen the comedones, so they should be avoided. Some mothers choose to apply breastmilk to neonatal acne.
Although breastmilk has been shown to improve eczema, there is no scientific evidence that it reduces baby acne. For neonatal acne, minimal intervention is best. By age four months, your baby’s skin should be free and clear of this type of baby acne.
Treating Infantile Acne
Infantile acne is managed with a two-step approach. First, it is important to evaluate for medical conditions that cause abnormal hormone levels. For example, the endocrine glands of some infants produce and release pubertal hormones too early. There may be signs at birth, such as abnormal genitalia, but this is not always the case.
A pediatric endocrinologist can help identify these disorders. Blood tests and an x-ray of the growth plates can be helpful.
Secondly, acne medication is often necessary to prevent scarring and long-term skin problems.
Because these medications are not routinely prescribed for infants, your primary care provider may refer your baby to a dermatologist.
The first-line treatment for infantile acne is a benzoyl peroxide or retinoid cream. For severe cases, oral medications may be considered. When prescribing these treatments for infants, care is taken to prevent long-term side effects and antibiotic resistance. Erythromycin is the antibiotic of choice due to its safety profile. In rare cases, oral isotretinoin is prescribed.
As with any medication, the benefits must be weighed against the risks.
So, to conclude, there is no one simple answer to the question about how to get rid of baby acne. In many cases, the condition will self-resolve, and the best we can do as parents is really to do nothing about it!
It is important to get the acne or rash diagnosed, to make sure your babe gets the correct treatment – if needed.
Unfortunately, there are not many home remedies that have proven helpful. Many parents wonder about breastmilk to treat baby acne, and while it is not likely to do any harm, there is no scientific evidence that it actually helps either.
So start with a proper diagnosis and take it from there!