Parenting Advice From Your Physicians at Kaiser Permanente

You’ve heard cute expressions like “soft as a baby’s bottom” or “baby-soft” to describe lovely, smooth skin. But new babies’ skin isn’t always so perfect – it’s often red, blotchy, and bumpy. There are many common imperfections you may see on your newborn’s skin, and most are nothing to worry about. Let’s take a look at some of them.

Baby Acne

These red bumps, pimples, and small pustules occur on the faces of about 1 in 5 babies. It often clears up in 1 to 3 months without any treatment and doesn’t cause scarring. Usually, all that’s needed is daily gentle cleaning with a mild baby soap. Avoid putting lotions or oils on the skin. If it looks red and irritated, you can use a thin layer of over-the-counter 1% hydrocortisone cream once or twice a day for no more than 1-2 weeks. If your baby has acne beyond 3 months of age, let their doctor know.

Eczema

This is a common condition that causes chronically dry and sensitive skin. It can first appear in infancy, usually as red, rough cheeks. A baby with eczema can have dryness all over and flared areas of red, itchy skin elsewhere. Treatment begins with making sure you’re using only mild, unscented soaps, detergents, and moisturizers. Usually, moisturizing baby’s skin from head to toe with a rich cream twice a day will help. Any areas that stay red and irritated can be treated with a thin layer of over-the-counter 1% hydrocortisone cream once or twice a day for no more than 1 to 2 weeks. If this treatment doesn’t clear up their skin, talk with your baby’s doctor to see if prescription medications are needed.

Rashes you might see on a newborn:

Erythema toxicum

Scary-sounding, but nothing to worry about! These are tiny white bumps surrounded by a red blotch and are found on a baby’s trunk or extremities. They usually appear within the first week of life. We don’t know much about what causes them, but they go away on their own.

Milia

These are tiny, pearly-looking white bumps often found on the faces of young babies. They are caused by the retention of keratin and sebum, which are normal skin components. No treatment is needed for these – they’ll shed on their own over time and leave no scars.

Heat rash

This is common in babies. It’s often seen on their chest and neck, but can be elsewhere, and forms tiny red or fluid-filled bumps. It’s also called prickly heat or malaria crystallina. It can occur if a baby is dressed too warmly and sweats. Besides routine bathing and dressing them a bit less warmly in breathable cotton clothing, no treatment is needed.

There are two main kinds of birthmarks.

Vascular Birthmarks

Strawberries, stork bites, and angel kisses? These are some of the names for birthmarks caused by the growth of extra blood vessels. They can be different sizes, may be raised and may look red, or pink. Most are benign and fade in time but ask your pediatrician about any you see on your baby.

Pigmentary Birthmarks

These are caused by areas of skin with increased pigment. One type, dermal melanocytosis (also called slate-grey spots), are patches of darker, grey-appearing skin. They appear on babies with pigmented skin, usually those of Asian, Black, or Hispanic heritage. These patches often occur on the lower back and bottom but can be elsewhere. They usually fade in time without any treatment.

Cradle Cap

Cap, not crap! This very common skin condition is also called seborrhea. It looks like reddish skin with oily, yellow scales on the scalp. It can also occur in the eyebrows, forehead, and behind ears. It’s not contagious, not an infection, usually doesn’t cause itching, and isn’t due to an allergy. It usually goes away after a few months. To treat cradle cap, wash your baby’s hair every other day. Before shampooing, soak and soften the scales with mineral or baby oil and use a soft brush to brush them out. If this isn’t working or the skin looks red and weepy, talk with your pediatrician.

So, feel reassured that, in most cases, your baby will have baby-soft skin soon. But although we also like to say, “sleeping like a baby,” that may take a bit longer too!

Resources for Parents

American Academy of Pediatrics

Baby Bathing and Skin Care