When parents bring a new baby home, they probably think the word “acne” won’t be said much around the house for about 13 years or so. But many babies actually get acne that looks very much like the teenage variety: red bumps and whiteheads surrounded by reddish skin that gets angrier when your baby is hot or fussy, or when the skin is irritated by saliva or rough fabric. Baby acne is quite common and can be divided into two types: neonatal and infantile.
You might see it: Soon after the baby is born, lasting for a few weeks.
Characterized by: Whiteheads (little white spots that contain cheesy material, a combination of sebum and keratin tissue) and pustules, which are white spots filled with pus.
Cause: Neonatal acne is directly related to the hormones coming from the mother at the end of pregnancy, according to Dr. Bernice Krafchik, a pediatric dermatologist in Toronto.
Treatment: No treatment required, it usually disappears on its own.
You might see it: At about two or three months, possibly persisting for up to a year.
Characterized by: In addition to whiteheads and pustules, infantile acne can include blackheads and papules (pink, brown or red bumps with no visible fluid inside).
Cause: Like adolescent acne, there’s no conclusive answer as to what causes it, but some think it may be an increase in male hormones, explaining why it is more common in boys.
Treatment: Usually infantile acne is short lived, and doesn’t seem much of a cause for concern. If it is more severe or appears to be getting worse, parents can ask their physician for a referral to a pedia tric dermatologist, who will start by confirming that it is acne and not another pustular disease. If treatment is necessary, the doctor will probably recommend that it be treated like teen acne: with topical antibiotics that may contain some benzoyl peroxide. In some cases the doctor may recommend an antibiotic that is taken orally.
Although it can look unattractive, infantile acne is not serious. “I’ve seen many, many cases of infantile acne, and none of them has ever amounted to anything,” says Dr. Krafchik. “It very seldom scars, and usually disappears on its own or with very minimal treatment.” What is more concerning is acne that occurs in later childhood. “Between the ages of one and six, children shouldn’t be getting acne at all. If they are, it could be the sign of another problem, like adrenal hypoplasia (atrophy of the adrenal glands).” Parents should never try to treat their baby’s acne in any way before talking to a doctor.
And does baby acne mean your child will be more prone to acne as a teenager? “That’s questionable,” says Dr. Krafchik. “There’s not enough research to back that theory up. What we do know is that the majority of neonatal and infantile acne cases have a very good prognosis, and that parents should not be concerned.”
Other baby skin conditions
Those bumps, red areas, rashes and other skin irritations on your baby’s face, head, neck, back and chest can be a number of things. A trip to the pediatrician will diagnose any of these common conditions:
Milia: Little keratinfilled cysts that are right under the skin and are often mistaken for whiteheads. They appear on the face after birth and usually clear up after a few weeks.
Cradle Cap: Also known as seborrhoeic dermatitis, it is a yellowish, scaly rash that occurs on the scalp of newborn babies. Nearly 50 percent of all babies get cradle cap. It usually clears up on its own before toddlerhood.
Eczema: Dermatitis, or inflammation of the skin, includes recurring rashes with any combination of redness, swelling, itching, crusting, flaking, cracking and blistering. There is no known cure – treatment is just intended to control the symptoms.
Roseola: Usually preceded by a high fever that lasts several days, it is a pink rash that starts on the torso and neck and may spread to the arms, legs and face. Most common in children between six months and three years of age.
Erythema Toxicum: Looks like mosquito bites or hives, it resolves without treatment after a few days or weeks.
Originally published in ParentsCanada magazine, February/March 2012.