Red rashes on newborns face

Newborn Rashes and Skin Conditions

Written by Steven Jerome Parker, MD

Reviewed by Dan Brennan, MD on July 23, 2021

Common Rashes in Newborns

Pink pimples ('neonatal acne') are sometimes thought to be caused by exposure in the womb to maternal hormones. No treatment is needed, just time. They can last for weeks or even months on a baby's skin.
Erythema toxicum is another common newborn rash. It looks like red blotches with ill-defined borders that are slightly raised, and may have a small white or yellow dot in the center. Its cause is unknown, and it resolves without treatment after a few days or weeks.
Dry, peeling skincan be seen in almost all normal babies, but is especially noticeable in babies born a little late. The underlying skin is perfectly normal, soft, and moist.
Little white bumps on the nose and face (milia) are caused by blocked oil glands. When a baby's oil glands enlarge and open up in a few days or weeks, the white bumps disappear.
Salmon patches (called a ''stork bite'' at the back of the neck or an ''angel's kiss'' between the eyes) are simple nests of blood vessels (probably caused by maternal hormones) that fade on their own after a few weeks or months. Occasionally, stork bites never go away.
Jaundiceis a yellow coloration on baby's skin and eyes. It is caused by an excess of bilirubin (a breakdown product of red blood cells). If the bilirubin level becomes sufficiently high, blue or white lights may be focused on the baby's skin to lower the level, because excess bilirubin can sometimes pose a health hazard.
Congenital Melanocytosis, previously called Mongolian spots, are very common in any part of the body of dark-skinned babies. They are flat, gray-blue in color (almost looking like a bruise), and can be small or large. They are caused by some pigment that didn't make it to the top layer when baby's skin was being formed. They are harmless and usually fade away by school age.

New rashes may appear in babies after a few days, weeks, or even months.

Common Rashes in the First Few Months of a Baby's Life

Cradle cap(seborrhea) often shows up at 1-2 months of age. Greasy, yellowish crusts appear on the scalp and may include a red, irritating rash on the face, behind the ears, on the neck, and even in the armpits. Your doctor will tell you how to best treat this common condition, depending on your baby's symptoms.
Eczemais red, itchy patches on the skin, often seen on the baby's chest, arms, legs, face, elbows, and behind the knees. It is caused by dry, sensitive skin, and sometimes allergies (although it can be difficult at this age to know what the trigger might be). Your doctor can determine if the rash looks like eczema and prescribe the appropriate treatment. In general, treatment consists of:
- Using a very gentle soap
- Using a gentle detergent and no fabric softener in baby's laundry
- Using skin moisturizers
- Applying a steroid cream (like hydrocortisone or even a stronger one) if the eczema won't go away
Prickly heat looks like small red bumps, mostly on areas of your baby's body that tend to overheat and sweat, like the neck, diaper area, and armpits. The treatment is to try to keep the area dry and avoid overheating by dressing them in loose-fitting clothing.
A fungal infection(candidiasis) can show up in different ways on your baby. On the tongue, it is called thrush and looks like dried milk, which, unlike milk, cannot be scraped off. In the diaper area, candidiasis looks like an intense red rash, often with smaller bumps around the edges. A fungal infection loves moist, dark areas, so you'll find redness due to it in the creases of the thighs. Candidiasis is treated with antifungal oral gel or liquid medicine (for oral thrush) or antifungal cream (for the diaper area), or both.

Tips for Concerned Parents

In the first few months of a baby's life, any rash associated with other symptoms (such as fever, poor feeding, lethargy, or cough) needs to be evaluated by a doctor as soon as possible.

When to Worry About Baby's Rash

While most rashes are not serious, a few need very close attention:

Fluid-filled blisters (especially ones with opaque, yellowish fluid) can indicate a serious infection, like a bacterial infection or herpes.
Small red or purplish dots over the body (''petechiae'') can be caused by a viral infection or a potentially very serious bacterial infection. These will not lighten with pressure. Any infant with possible petechiae should be evaluated by a doctor immediately.

Newborn Rashes and Birthmarks

Is this your child's symptom?

Normal skin rashes and birthmark questions about newborns

Newborn Rashes - Topics Covered

If your baby is healthy, skip the "What to Do" section. Go directly to the topic number that relates to your question for advice.

Acne. Small red bumps on the face (onset 2-4 weeks).
Drooling or Spit-Up Rash. Rash around the mouth and on the chin (onset anytime).
Erythema Toxicum. Red blotches with small white "pimple" in the center (onset 2-3 days).
Skin Injury from Birth Process. From forceps, scalp electrode or birth canal (present at birth).
Milia. Tiny white bumps on the nose and cheeks (present at birth).
Mongolian Spots. Bluish-green birthmark, often on buttock (present at birth).
Stork Bites (Pink Birthmarks). On back of neck or bridge of nose (present at birth).
Strawberry Hemangiomas. Raised red birthmarks (onset 2-4 weeks).
Port-wine Stains. Dark red or purple flat birthmarks (present at birth).

Newborn Face Rashes: Most Common Ones

Erythema Toxicum 50% (onset day 2 or 3)
Milia 40% (present at birth)
Baby Acne 30% (onset week 2 to 4)
Drooling or Spit-up Rash (common and onset any time)
Heat Rash (common and onset any time)

Heat Rash

Many newborn rashes that have no clear cause are heat rashes.
Heat rashes are a pink blotchy area with tiny bumps.
They mainly occur on the face, neck and chest.
During hot weather, most temporary newborn rashes are heat rashes.
Cause: blocked off sweat glands. The openings are so tiny in newborns, that any irritation can block them. Examples are getting any ointment on the skin, friction from clothing or being overheated. Being held against the mother's skin while nursing causes many face rashes.

Herpes Simplex: Serious Newborn Rash

Appearance. Several water blisters or pimples grouped in a cluster. They look like the cold sores (fever blisters) that adults get on their lip. After several days, they crust over.
Location. Just one part of the body, usually the scalp or face.
Redness. The base can be pink. The pinkness does not extend beyond the cluster of vesicles.
Onset. Within the first 2 weeks of life.
Importance. Early treatment with anti-viral drugs can prevent serious problems. If you think your newborn's rash looks like herpes, call your child's doctor now.
Imitator. Although herpes can be confused with erythema toxicum, they look very different.

When to Call for Newborn Rashes and Birthmarks

Call 911 Now

Not moving or very weak
You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

Age less than 1 month old and looks or acts abnormal in any way
Fever in baby less than 12 weeks old. Caution: do NOT give your baby any fever medicine before being seen.
Purple or blood-colored spots or dots not present at birth
Tiny blisters (little bumps that contain clear fluid)
Pimples (little bumps that contain pus). Exception: looks like erythema toxicum which occurs in half of newborns.
Skin looks infected (such as spreading redness, sores or pus)
Rash is painful to touch
You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

Mild newborn rash, but cause is not clear
You have other questions or concerns

Self Care at Home

Normal newborn rashes or birthmarks

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Bellevue
Everett
Federal Way
Seattle

Care Advice for Newborn Rashes and Birthmarks

Acne:
- More than 30 percent of newborns develop baby acne of the face. Acne consists of small red bumps.
- This baby acne begins at 2 to 4 weeks of age. It lasts until 4 to 6 months of age.
- The cause appears to be the transfer of maternal hormones just prior to birth.
- Since it goes away on its own, no treatment is needed. Baby oil or ointments make it worse.
Drooling or Spit-up Rash:
- Many babies have a rash on the chin or cheeks that comes and goes. This is often due to contact with food. It's more common after starting baby foods. In newborns, it can also be from stomach acid that has been spit up. Prolonged contact with spit-up during sleep can cause the rash to get worse.
- Other temporary rashes on the face are heat rashes. These can occur in areas held against the mother's skin during nursing. Heat rashes are more common in the summertime.
- Rinse the face with water after all feedings or spitting up. During hot weather, change the baby's position more often. Also, put a cool wet washcloth on the rash. Do this for 10 minutes.
Erythema Toxicum:
- More than 50 percent of babies get a rash called erythema toxicum. It starts on the second or third day of life.
- It's a harmless baby rash that doesn't need to be seen.
- The rash is made up red blotches. They are ½ inch to 1 inch (1 to 2.5 cm). The blotches have a small white or yellow "pimple" in the center.
- They look like insect bites, but are not. Red blotches are the main feature.
- They can be numerous, keep occurring, and look terrible. They can occur anywhere on the body surface, except the palms and soles.
- Their cause is unknown, but they are not an infection.
- They go away by 1-2 weeks of age.
- No treatment is needed. Ointments or baby oil make it worse.
Skin Injury from Forceps, Scalp Electrode or Birth Canal:
- The pressure of a forceps on the skin can leave marks. You may see bruises or scrapes anywhere on the head or face.
- During birth, skin overlying bony prominences can become damaged. You might see this on the sides of the skull bone. This is from pressure from the birth canal. Even without a forceps delivery, you may see bruises or scrapes.
- Scalp electrodes can also cause scalp scrapes and scabs.
- The bruises and scrapes will be noted at birth. They will be more noticeable by day 2. They heal over or go away by 1 - 2 weeks of age.
- A fat tissue injury won't appear until day 5 to 10. Look for a firm coin-shaped lump. It will be under the skin and sometimes with a scab. This lump may take 3 or 4 weeks to go away.
- For any breaks in the skin, apply an antibiotic ointment (such as Polysporin). No prescription is needed. Use 3 times per day until healed.
- Call Your Doctor If:
- It becomes tender to the touch
- Becomes soft in the center
- Starts to looks infected
Milia:
- Milia are tiny white bumps that occur on the face. The nose and cheeks are most often involved. Milia can also be seen on the forehead and chin.
- Milia occur in 40 percent of newborn babies. Present at birth.
- Milia are many in number. They occur equally on both sides of the face.
- Although they look like pimples, they are much smaller (pinhead size). They are not infected.
- They do not look like water blisters.
- They are blocked-off skin pores. They will open up.
- Milia will go away by 1 to 2 months of age.
- No treatment is needed. Ointments or creams can make them worse.
Mongolian Spots:
- A Mongolian spot is a normal bluish-green or bluish-gray flat birthmark. They occur in over 90 percent of Native American, Asian, Hispanic, and African American babies. They are also seen in 10 percent of Caucasians, especially those of Mediterranean descent.
- They are present at birth.
- They occur most commonly over the back and buttocks. However, they can be present on any part of the body.
- They vary greatly in size and shape.
- They do not indicate illness or any disease.
- Most fade away by 2 or 3 years of age. A trace may last into adult life.
Stork Bites (Pink Birthmarks):
- Flat pink birthmarks that occur over the bridge of the nose or the eyelids. You can also find them on the back of the neck ("stork bites"). The ones in front are often referred to as "an angel's kiss".
- They occur in more than 50 percent of newborns. They are present at birth.
- All the birthmarks on the bridge of the nose and eyelids clear completely. Those on the eyelids clear by 1 year of age. Those on the bridge of the nose may last for a few more years. Those on the forehead from the nose up to the hairline usually last into adulthood. Laser treatment during infancy should be considered. Most birthmarks on the nape of the neck also clear. But, 25 percent can last into adult life.
Strawberry Hemangiomas:
- Strawberry hemangiomas are red birthmarks that are raised or increasing in size.
- Onset usually between 2-4 weeks of age. Most often, start after 3 weeks of age. Sometimes (although rare), they don't appear until the second month of life.
- They become larger for 1 year. Then, they fade away over 6 to 8 years without any treatment.
- They run a small risk of bleeding with trauma. Any bleeding should stop with 10 minutes of direct pressure.
- Discuss with your child's doctor on the next regular visit. Call sooner if you are concerned.
Port-Wine Stain Birthmarks:
- Present at birth in 1 out of 200 newborns
- Deeper in color (dark red or purple) than stork bites (salmon patches)
- Flat, smooth surface
- Natural course: Do not fade or disappear like stork bites. May become darker.
- Grow with the child, but cover the same area
- Treatment: May refer to dermatologist for laser treatments early in infancy
Call Your Doctor If:
- Your baby starts to look or act abnormal in any way
- You think your child needs to be seen

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 11/03/2022

Last Revised: 01/13/2022

How to care for the skin of a newborn.

After discharge from the hospital, mother and baby gradually get used to the daily routine. The child should eat well and be warm - this is the first on the list. No less important is the care of the skin of the baby, which is very delicate and sensitive to external stimuli. To adapt to the new environment, the baby needs time and care of parents. Chemicals, fragrances, dyes in clothes, and detergents cause redness, diaper rash, or a rash. How to properly care for the skin of a newborn to protect the child from contact dermatitis, allergies, and other rashes?

Bathing

The baby is born with a protective coating. During this period, there is no need to bathe the baby or use baby lotions and creams.

A full bath is normal from the first days of a baby's life, the main thing is to follow the rules:

- bathe your baby in a warm room.

- water should be at body temperature: 36-37 degrees to the touch.

- make sure the necessary items for the procedure are within reach. - remove jewelry that can scratch the child.

- hold the newborn firmly by lifting his head above the water.

- do not use cotton swabs to clean the nose and ears.

- To wash your baby's face, use water without soap.

- never leave a child unattended while bathing, even for a moment.

- For the first 2-3 months after birth, give up shampoo and soap, which can cause an allergic reaction in the baby.

- if you do use baby bath products, make sure they are soft, suitable for babies and odorless.

- then carefully wrap the baby in a cotton towel or a special corner robe for newborns.

- the room in which the baby will be after the bath should be warm, and air conditioners and fans should be turned off to prevent colds.

Umbilical cord care

By the time of discharge from the hospital, this organ, which connected mother and baby during all 9 months of pregnancy, will begin to dry out. Gradually, the umbilical cord atrophies and falls off within 1-2 weeks. Until then, the place of its attachment to the belly of the newborn must be kept clean and dry. All you need is plain water. You can not pull the keratinized part, even if it begins to fall off. The process will end by itself. To protect your baby's delicate skin, buy diapers for newborns that have a notch in the waistband for the unhealed navel. If you are using regular diapers, fold the edge so that the fabric does not rub against the tummy. In some cases, the child may need a doctor. Contact your pediatrician if your child has a fever of 38°C or more along with changes in the navel: the area is red and swollen; oozing yellow pus; there is an unpleasant smell. Many mothers are worried about the appearance of small specks of blood on the baby's undershirt or diaper, the child's bed. A little bleeding is normal.

Diapers and diapers

Change diapers more often as soon as you notice that they are wet or dirty. If left for too long, it can cause infections. For newborn hygiene, thoroughly clean the genital area after every diaper change. Wash your baby under warm, running water to prevent irritation. Allow a few minutes for the skin to air dry, or gently pat dry with a soft towel. Use baby wipes less often to care for your newborn's skin. Perfume and alcohol in them can cause irritation, cause a rash. Make sure you buy diapers in a size that fits your baby. If the baby's skin in the diaper area is irritated, choose a different brand or stop using them for a while. . Wash reusable diapers and diapers with a mild, unscented detergent or clean, hot water. Most diaper rashes on a newborn's skin are not dangerous, but some can be a sign of an infection and need to be looked after. If the baby's skin is very reddened, itchy, or causes pain, contact your pediatrician immediately.

What to do in case of skin problems

In the first months after birth, the baby may develop a rash, irritation, diaper rash, which seem unusual to parents.

Most of the newborn skin problems do not need treatment:

- baby pimples - a small red rash on the face. As a rule, it disappears over time without intervention.

- milia are tiny whiteheads on a child's face.

- erythema is a common patchy rash that can affect newborns. Some appear as yellow or white bumps surrounded by a red halo. The rash tends to migrate to different parts of the body. It is most common on the second day of life, but may appear at birth or within the first two weeks. There is no cure - erythema gradually disappears on its own.

Eczema

This rash appears as red bumps that may fester. It usually appears on the forehead, cheeks, or scalp, and sometimes spreads to other parts of the body. The risk group includes infants who suffer from allergies from birth or have a genetic predisposition to the disease. In case of pathology, it is recommended to use special moisturizers: ointments, creams, oils. Do not bathe the baby for a long time with this disease. When an allergic rash appears, a consultation with a pediatrician is required.

Diaper rash

Causes:

- untimely diaper change. Urine or stool in a diaper irritates a newborn's skin, causing red weeping spots.

- bacterial or yeast infection. Taking antibiotics can cause the growth of fungi of the genus Candida. It usually appears around the genitals and buttocks of an infant. It looks like red spots with a whitish coating.

How to properly care for your skin to prevent diaper rash:

- do not use reusable diapers frequently.

- give up talcum powder: it dries out the skin of a newborn.

- air baths for half an hour. Heat rash is caused by overheating of the body. It is usually visible in the folds of the baby's skin. Hot, humid weather is a favorable time for prickly heat. To avoid rashes, keep your newborn cool by dressing him in loose cotton clothing.

Contact dermatitis

This disease develops when an infant's skin comes into contact with an irritant. The rash appears at the points of contact with the allergen: metal latches on T-shirts; dyes in clothes; washing powder; inappropriate soap, shampoo; allergic to the oil used. Parents need to trace, after which rashes appear, and eliminate the irritant. To bathe the baby, you need to use shampoo and soap that do not cause allergies in the newborn; iron baby clothes before putting them on. For washing, special powders or gels are used that do not contain fragrances and dyes, the child's clothes, bed linen and blankets are washed separately from the family's wardrobe items.

Rashes in infants | Rassvet Clinic

Babies are generous with various rashes. According to the "good" tradition, most of them are considered allergic with all the consequences - a strict diet for a nursing mother, transfer to artificial feeding, prescription of therapeutic mixtures, etc. In fact, true allergic rashes in infants are not so common. Allergic diseases affecting the skin in infants include: atopic dermatitis, acute urticaria and angioedema. Acute urticaria is extremely rare in infants - this is an acute allergic reaction in the form of peculiar rashes like blisters (as with a nettle burn, hence the name), which suddenly appear on the skin and just as suddenly disappear without leaving any trace, usually do not exist on the skin for longer than a day and are accompanied by severe itching, which manifests itself in the general anxiety of the child. The most common causes are dietary proteins (such as cow's milk), viral infections, insect bites, and drugs (such as antibiotics). In severe cases, it may be accompanied by swelling and redness of the soft tissues of the face, neck, larynx, arms, legs, genitals or abdominal cavity - Quincke's edema, which requires immediate medical attention.

Let's look at what is most often undeservedly called an allergy:

Toxic erythema newborns - a transient benign rash, the exact cause of the appearance is unknown (possibly due to skin irritation by environmental factors).

Appears at birth or in the first 24-48 hours of life. Localization - face, trunk, limbs, except for the palms and soles. Disappears on its own within 5-7 days, sometimes 3 weeks. Does not require treatment.

Neonatal acne (acne infancy, neonatal pustulosis) is caused by androgen stimulation of the baby's sebaceous glands.

Peak rash falls on the 3rd week of life. It is localized more often on the face, sometimes spreads to the scalp, less often to the collar zone. They resolve spontaneously. The skin needs cleansing and moisturizing, in some cases, the application of
treatment creams may be required.

Sweating rash , which occurs in poorly "ventilated" areas as a result of blockage of the sweat glands. May occur at any age.

Localization - skin folds, buttocks and back surface of the body, sometimes the face (after sleep). Depending on the depth of the lesion, it happens - crystal prickly heat, prickly heat, deep prickly heat (superficial).

The duration of the rash is from several hours to several days.

Treatment - cool water baths, air baths, prevention of overheating. Lotions containing calamine and creams with corticosteroids and antibiotics may be used to treat some cases of red and deep prickly heat.

Seborrheic dermatitis is a skin disorder that develops in areas rich in sebum. The exact cause is unknown (a certain role is assigned to the skin saprophyte - the Malassezia fungus, which grows well and multiplies in the sebaceous secretion).

It can be foci or widespread, dermatitis with bran-like scales, which can form a crust (“cap”, gneiss) on the scalp.

Favorite localization - scalp, face, folds (!).

May begin at or after the 1st to 2nd week of life, resolves spontaneously within a few weeks or months.

Treatment consists of softening the crusts with oil or cream and then removing them, moisturizing the skin and, in some cases, applying antifungal and anti-inflammatory creams.

Simple contact dermatitis is a non-specific skin injury due to prolonged or repeated exposure to a variety of substances - saliva, fruit juices, foaming bath products, detergents (their residues on the walls of the bath), etc. In infants, saliva is often causes dermatitis in the area of contact with the nipple and in the folds of the neck.

As a rule, removal of the damaging agent and short-term use of anti-inflammatory creams leads to a quick recovery, but some children are so sensitive that it is almost impossible to identify the causative factor.

Diaper dermatitis (prototype of contact dermatitis) is a skin lesion that occurs under the influence of physical (overheating), chemical, enzymatic (contact with sweat, urine and feces) and microbial factors. Localization - the area of the diaper or diaper fit.

Treatment is carried out using the abbreviation ABCDE (air, barrier, cleansing, diaper, education) - air, barrier, cleansing, diaper and parent education. Frequent diaper changes, washing the skin and drying it thoroughly help. Dermatitis is effectively prevented by the application to clean skin of products that completely cover it (Vaseline, zinc paste). In stubborn cases, medicated creams containing corticosteroids, antibiotics, or antifungals may be recommended.

And now a few words about AD:

Atopic dermatitis is a chronic allergic inflammation of the skin, genetically determined, associated with the loss of the skin barrier and, therefore, accompanied by dryness, itching and various rashes. In a third (!) of cases, it is combined with food allergies (the most common "culprits" are cow's milk, chicken eggs, wheat, fish, soy, nuts).

Starts more often not earlier than 3 months of life.

The most common localization up to 2-3 years is the face (cheeks, forehead, chin), convex parts of the limbs (extensor surfaces) and trunk, never in babies in folds (!).

Exacerbations are provoked by various factors - stress, dry air, sweat, food (histamine liberators), infections, contact with tobacco smoke, animal hair, coarse fabrics, detergent residues on clothing, etc.

Treated with careful skin care and using anti-inflammatory creams.

There are also:

Pseudo-allergic reactions are reactions that look similar to allergic reactions (for example, various rashes), but are not such, due to the non-immune mechanism of their development.

The reason is an increased content of histamine (tyramine, serotonin) in foods, or the ability of foods to increase the release of these substances in the body, or their increased absorption, due to the pathology of the gastrointestinal tract (fermentopathy, inflammation in the intestinal wall, etc.). ). Such products include chocolate, cocoa, strawberries, citrus fruits, honey, sauerkraut, marinades and spices, seafood, fish, caviar, pork, mushrooms, cheeses, nuts, smoked meats, preservatives, dyes and flavor enhancers.

Treatment includes dietary advice, skin care, and in some cases, antihistamines and anti-inflammatory creams.

Clinical manifestations of atopic dermatitis, simple contact dermatitis in highly sensitive children and the manifestation of pseudo-allergic reactions are very similar to each other, so the main task remains to create a "skin barrier" by constantly moisturizing the skin with the help of emollients, stopping exacerbation with anti-inflammatory creams and eliminating exacerbation provoking factors .