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Baby Acne: What Is It, and What Causes It?

Baby Acne Is Mild Acne That Develops in Some Newborn Babies Because of Hormone Fluctuations after Birth

Last updated: April 09, 2019

Article Summary

About 1/5 of babies, mostly baby boys, are born with acne or develop it in the first six weeks of their lives. This baby acne is usually mild and appears on the face. 

Baby acne occurs due to fluctuating hormones after birth, so it usually disappears in a few months when hormone levels normalize. 

No treatment is necessary unless baby acne is severe or fails to go away on its own. In such cases, doctors recommend topical treatments. 

People who experience baby acne are more likely to develop more severe acne as teens than people who never had baby acne.

Baby acne, also known as neonatal acne, is acne that a baby is born with or that develops in the first six weeks of a baby's life. Baby acne occurs in about one fifth of babies, usually in baby boys. It normally appears on the face. Baby acne is typically mild and goes away on its own after 1 to 6 months.1-4

In most cases, baby acne occurs for the same reason teen acne does: hormone fluctuations. We rarely think of babies as having "raging hormones," but, in a way, they do. 

A Baby's Raging Hormones

Before birth

Before a baby is even born, while still in its mother's womb, it receives androgens (male hormones that are present in both males and females) from its mother.2 Just like in teens and adults, these androgens stimulate a baby's skin to produce more skin oil. Sometimes, too much skin oil is produced, and this, in turn, can be the first step in developing acne.

After birth

Once the baby is born, its own adrenal glands (small organs located on top of the kidneys) take over the job of producing androgens. In baby boys, the testicles also produce androgens. This means baby boys produce more androgens than baby girls. All these androgens can sometimes result in the skin producing too much skin oil, which is one of the primary reasons that boys are more likely to suffer from baby acne.2,5

After 6 months of age

Both male and female babies' adrenal glands are particularly large from birth to 6 months, which means that they are making more androgens than they will later in infancy. When a baby is between 6 months and 1 year old, its adrenal glands gradually shrink. As a result, the glands stop producing such large amounts of male hormones. As hormone levels normalize, the skin stops producing so much skin oil, and baby acne naturally clears up.2,4,5

Factors That Contribute to Baby Acne

Aside from hormones, several additional factors can contribute to baby acne:

  • Family history: A family history of acne or of elevated male hormone levels makes a child more likely to develop baby acne
  • Certain skin bacteria: Having a type of fungi called Malassezia in the skin pores might trigger inflammation (redness, swelling, and soreness) in the baby's skin, causing baby acne. However, this theory is controversial since not all babies with baby acne have this type of fungi.2,5

Baby Acne - Boys Vs. Girls

What Does Baby Acne Look Like?

Baby acne looks similar to mild teen acne. According to a study published in the International Journal of Dermatology, The majority of the babies' acne lesions were papules and pustules--inflamed and red lesions that most people refer to as "pimples" or "zits." However, they had some whiteheads and blackheads--clogged pores that appear as small, non-inflamed white or black dots on the skin--as well.1

Baby Acne Whitehead Blackhead Papule Pustule

baby Acne Types of Lesions

Where on the Face Does Baby Acne Occur Most?

Most of the babies' acne lesions--81.8%--were on the cheeks, with occasional lesions on the back and chest.However, another article in the medical journal Dermatologic Clinics notes that baby acne can also appear on the forehead and nose.The researchers noted that, on average, the babies developed acne at 3 weeks of age, and the condition lasted 4 months.1

How Do You Treat Baby Acne?

Normally, baby acne requires no treatment. Between 6 months and 1 year of age, androgen levels drop off naturally, and baby acne usually clears up on its own.4

Cutis

According to a 2014 article in the medical journal Cutis (meaning "skin"), "Guardians should be reassured that [baby] acne is mild, self-limited, and generally [goes away on its own] without scarring in approximately 1 to 3 months. In most cases, no treatment is needed."2 

In most cases [of baby acne], no treatment is needed

In rare cases, baby acne may fail to heal on its own. Severe baby acne can also be concerning because it may leave scars. In such cases, doctors recommend topical treatments which are available over-the-counter. The suggested treatment depends on the type of acne lesions the baby has.

  • If the baby has mostly papules and/or pustules: Doctors often recommend 2% topical erythromycin + 2.5% benzoyl peroxide
  • If the baby has mostly whiteheads and blackheads: Doctors often recommend 20% azelaic acid cream + 0.025 - 0.05% tretinoin cream2,5

The baby's doctor may have to tweak these recommendations depending on how severe the baby's acne is. 

Topical treatments like these should effectively clear baby acne. If they do not, the baby's parents should consult a doctor to make sure the acne is not a sign of an underlying condition like a hormonal problem or infection by bacteria or a virus.2,4  

When It Is Severe, Actively Treating Baby Acne Can Help Reduce Severity and Scarring

Similarly, if a baby's acne persists past the age of 1, it is important to see a doctor to rule out other potential medical issues.2,4

Baby Acne Vs. Other Types of Acne

Baby acne falls under the larger umbrella of so-called pediatric (children's) acne. Pediatric acne is any acne that develops when a child is younger than 12 years old. Baby, or neonatal, acne is the earliest type of pediatric acne that typically begins at birth or up to 6 weeks of age.3

Onset of Pediatric Acne Types

A baby who develops baby acne is more likely to suffer from adolescent (teen) acne when he gets older. People who experienced baby acne are also more likely to develop more severe adolescent acne than people who never had baby acne.1-3

Baby Acne Facts Summary

The Bottom Line

Baby acne affects about 1/5 of babies, mostly baby boys. It usually appears on the baby's face within the first 6 weeks of his life. Baby acne is usually mild and goes away on its own, so it is rarely a cause for concern. However, baby acne that is severe or fails to disappear on its own requires topical treatment. If treatment does not work, it is important to see a doctor to rule out other underlying conditions like infections.

The Experts at Acne.org

Our team of medical doctors, biology & chemistry PhDs, and acne experts work hand-in-hand with Dan (Acne.org founder) to provide the most complete information on all things acne. If you find any errors in this article, kindly use this Feedback Form and let us know.

References:

  1. Katsambas, A. D., Katoulis, A. C. & Stavropoulos, P. Acne neonatorum: A study of 22 cases. Int J Dermatol 38, 128 - 130 (1999).
  2. Serna-Tamayo, C., Janniger, C. K., Micali, G. & Schwartz, R. A. Neonatal and infantile acne vulgaris: An update. Cutis 94, 13 - 16 (2014).
  3. Samycia, M. & Lam, J. M. Infantile acne. CMAJ 188, E540 (2016).
  4. Maroñas-Jiménez, L. & Krakowski, A. C. Pediatric Acne: Clinical Patterns and Pearls. Dermatol Clin 34, 195 - 202 (2016).
  5. Herane, M. I. & Ando, I. Acne in infancy and acne genetics. Dermatology 206, 24 - 28 (2003).

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