The skin of newborns (aged 0-30 days) undergoes a variety of changes in the first month of life. Their skin is more sensitive than adults, making them prone to develop different types of rashes.
Most newborn rashes are normal physiological adaptations of the delicate newborn skin to new environments. Fortunately, they are usually self-limiting (i.e. will disappear on their own) or harmless in nature, and do not require any specific treatment.
However, if the condition worsens or other serious symptoms appear, like fever or refusal of feeding, consult your paediatrician for a check-up. Here are some common rashes that can develop in newborns.
Baby acne (neonatal acne)
Babies may develop small white/red pimples on their nose, cheeks and forehead. These pimples may appear at birth or within a month of life, and usually clear up without any treatment. They occur due to the effect of hormones transmitted from mother at the end of pregnancy.
Management: Wash baby’s face with water and mild baby soap. Apply gentle moisturisers. Do not use over-the-counter acne medicines or oily lotions.
Cradle cap (seborrhoeic dermatitis)
Babies may develop yellowish, greasy, flaky, dry skin on the scalp, neck, ears, eyebrows, armpits, and sometimes, at the diaper area, where it is known as diaper rash. Cradle cap usually starts to occur as early as two weeks of life, and resolves at the latest by one year of life. It is not caused by allergies or poor hygiene. Some babies may develop eczema over the skin folds.
Management: Wash hair with water and mild baby shampoo. May use mild baby oil to soak the scales before gently brushing them off while washing.
Heat rash (miliaria)
Heat rashes are tiny red bumps appearing on any part of the body, but usually over the back, head and neck areas. They occur due to partial blockage of sweat glands. Hot and humid environments or excess clothing may aggravate heat rash.
Management: Keep the affected area dry. Ensure that baby stays in a cool environment. Dress baby in light breathable clothing.
These are inflamed red rashes in the diaper area and commonly occur in babies under one year of age and/or those wearing diapers. It is caused by prolonged exposure of the diaper area to the baby’s urine/stool or yeast/bacterial infections due to infrequent or slow changing of diapers.
Management: Keep the diaper area dry and clean by changing diapers frequently. Clean with water, pat dry and apply barrier ointment during every diaper change. Consult your doctor if the rash persists. The doctor may prescribe antifungal or antibiotic cream in the presence of any infection.
These are small red blotches that appear mainly on the body, face and limbs. They often appear at two to five days after birth and go away in a couple of weeks. The cause is unknown. These rashes do not bother the baby.
Management: No specific treatment is needed. Gentle washing with mild baby soap may be helpful.
Neonatal sebaceous hyperplasia
These are tiny yellow papules or spots on the nose, cheeks and forehead. They occur due to overgrowth of sebaceous glands (sebum-secreting glands), which are probably induced by hormones transmitted by mother during the pregnancy. Usually appears in the first week of life.
Management: No treatment is needed. It will resolve within a few weeks.
When to be concerned
The rashes above are usually harmless and will resolve spontaneously over few weeks without any treatment. However, if any of the conditions become extensive or severe and prolonged, consult your child’s paediatrician for a proper diagnosis and treatment.
Other skin rashes that may need you to consult your child’s paediatrician include hives or wheals on the skin, which may indicate an allergic response, especially to food. Your doctor can help to identify the allergens.
Also, rashes accompanied by other symptoms such as fever, pain, poor feeding or irritability, may be signs of skin infections like impetigo, or even other serious or fatal infections like meningitis.