Baby Skin Conditions: What’s Normal, and When To Worry

Did you know that as many as one in two newborn babies suffer from skin irritations in their first few weeks? It’s pretty common! Although most of them go away on their own, they can be worrisome for new parents. So what are the most common rashes and irritations to look out for?

The most common rash that appears on newborn skin is erythema toxic neonatorum. It affects up to 50% of babies, usually in the first few weeks of life. Although it has an scary sounding name and can look unpleasant (small red bumps and pimples spread over the baby’s body and limbs), it is actually harmless and will disappear spontaneously without treatment.

Another common skin irritation is miliaria, also known as a sweat rash. Babies are particularly susceptible to it because of the immaturity of their sweat ducts. This can be mitigated simply by ensuring that the baby does not overheat.

A newborn’s skin is prone to rashes of all sorts, and these can include rashes relating to yeast, viral, or bacterial infections. Fortunately, most of these rashes are harmless and go away on their own, but you should still call MacKoul Pediatrics immediately if your baby develops a new rash — especially one associated with other symptoms (such as fever, poor feeding, lethargy, or cough).

Here is a breakdown of what you can expect:

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 skin can 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 simply 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.
• Jaundice is 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.
• 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.

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. MacKoul can tell you how to best treat this common condition, depending on your baby’s symptoms. Eczema (atopic dermatitis) is red, scaly, or itchy patches on the skin, often seen on the baby’s chest, arms, legs, face, elbows, and behind the knees — and especially in areas of the body that are prone to overheating, such as the groin. Eczema is caused by a gene mutation that inhibits the body’s natural ability to repair damage to the skin barrier. Most skin cells have two copies of the gene, but people who are susceptible to eczema only have one. This is why this condition especially occurs around the diaper area: there are multiple strains on the skin in this area, including heat, as well as irritation from urine and faeces. This means the body is replacing the skin cells in this area more frequently than in other places. You should wash this skin with plain water after every diaper change. Applying a thick diaper cream regularly to the area can reduce this likelihood of developing a problem. MacKoul Pediatrics 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 him 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 most of the redness 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.

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 and remain the same color when you push on the skin. Any infant with possible petechiae should be seen at MacKoul Pediatrics immediately.
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• If you have any concerns about a rash your baby might have, please don’t hesitate to give MacKoul Pediatrics a call!

About author MacKoul Pediatrics

MacKoul Pediatrics is an amazing local pediatrics office in Cape Coral, FL where caring, compassionate doctors and nurses work with you to keep your children as healthy as possible. MacKoul cares for children from birth to college age, from Cape Coral, Fort Myers, Naples, and beyond.