Infant acne: what to do if your baby has spots?

Neonatal acne is common and affects 20% of infants under six weeks of age.

From birth, a newborn may develop small spots that are red (skin lesion), white (excess sebum), or even pink. These appear mainly on the skin of the face, particularly on the cheeks, forehead, nose, and chin, though they can sometimes be found in the hair, on the shoulders, and on the chest. Similar to adult acne, the symptoms of neonatal acne also include spots, small bumps, skin lesions, and pustules. 

These spots are often unsightly, even alarming, but they do not cause itching. The skin lesions also leave no scarring. 

No need to panic — this is most likely neonatal acne. Nearly 20% of babies are affected in the first months of life, and it is almost always entirely harmless.

Neonatal acne should not be confused with milia, which are small, hard white spots linked to the immaturity of the sweat glands, or with heat rash, which can appear during the summer months on your baby's skin, particularly on the scalp and chest.

Do not confuse these with cradle cap either. Cradle cap consists of whitish, greasy patches found mainly on the scalp.

The causes of infantile acne appearing on a baby's skin cannot be stated with certainty. Several factors have been implicated in the aetiology of neonatal acne, namely increased seborrhoea, stimulation of the sebaceous glands by maternal or neonatal androgens, and Malassezia species (yeasts). 

Many experts agree that this is likely linked to the mother's hormones towards the end of pregnancy. These are present in the placenta and can therefore affect the baby's skin sebum production. When overproduced, this can block pores and lead to acne.

Furthermore, newborns have sensitive skin at birth. It can react negatively to anything that remains on it for too long, especially if there are residues of food, vomit, or dribble.

Although both conditions look similar, the difference between baby acne and infantile acne is the age at which it affects the child. 

Neonatal acne appears on average around 14 days of age. 

Infantile acne occurs between 2 months and 1 year of age. It is similar in appearance, with a male predominance, but includes comedones, blackheads, nodules and cysts. The symptoms of infantile acne can go beyond pustules and bumps. Infantile acne is much less common and affects fewer than 2% of children. Infantile acne may take longer to clear up. Unlike neonatal acne, infantile acne can leave scars.

If your child develops acne after the age of 2 months, consult a healthcare professional, as this may be a sign of an underlying issue.

Baby acne generally clears up on its own after a while, without any treatment. 

It is best not to touch the spots and in particular not to squeeze them. We advise against applying any treatment such as a lotion or cream without medical advice. Pay close attention to the quality of your skincare products. Some products (rich formulations, etc.) or habits can make the situation worse.

The right approach includes cleaning your baby's acne-prone skin with water or saline solution. Do not use any other products. Some practitioners even recommend using breast milk to soothe the skin. Make sure to dry the area thoroughly afterwards using cotton wool or a clean towel.

Our other tips include cleaning any food residue or vomit from your baby's face after a mishap. Make sure to take care of their skin every day.

We also recommend seeking advice if the acne has not cleared up after a few weeks. In addition, if there are any other symptoms such as blisters, peeling skin, irritability, fever or feeding difficulties, seek medical attention immediately.

Infant acne should clear up quickly in your baby. If after a few months you see no improvement, consult a healthcare professional (doctor, paediatrician or dermatologist).

If you have any concerns, do not hesitate to bring them up at your monthly appointments with your paediatrician.

It is worth noting that infant acne has no connection with teenage or young adult acne. The fact that your baby had red spots during their first few months does not mean they will have acne as a teenager.