Newborn Rashes and Birthmarks

Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 6/1/2011
Last Revised: 8/1/2011
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.

1. Acne:
• More than 30 percent of newborns develop baby acne of the face -- mainly small red bumps.
• This baby acne begins at 3 to 5 weeks of age and lasts until 4 to 6 months of age.
• The cause appears to be the transfer of maternal hormones just prior to birth.
• Since it is temporary, no treatment is necessary. Baby oil or ointments make it worse.
2. Drooling Rash:
• Many babies have a rash on the chin or cheeks that comes and goes. This is often due to contact with food and acid that has been spit up from the stomach (especially prolonged contact during sleep).
• Other temporary rashes on the face are heat rashes in areas held against the mother's skin during nursing (especially in the summertime.)
• Rinse the face with water after all feedings or spitting up. During hot weather, change the baby's position more frequently and put a cool washcloth on the area.
3. Erythema Toxicum:
• More than 50 percent of babies get a rash called erythema toxicum on the second or third day of life.
• It's a harmless baby rash that doesn't need to be seen.
• The rash is composed of ½ inch to 1 inch (1 to 2.5cm) red blotches with 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, be present anywhere on the body surface (except the palms and soles), and look terrible.
• Their cause is unknown, but they are not an infection.
• They resolve by 2 weeks of age.
• No treatment is necessary; ointments or baby oil make it worse.
4. Forceps or Birth Canal Injury:
• The pressure of a forceps on the skin can leave bruises, scrapes, or damaged fat tissue anywhere on the head or face.
• Skin overlying bony prominences (such as the sides of the skull bone) can become damaged even without a forceps delivery by pressure from the birth canal.
• Fetal monitors can also cause scrapes and scabs on the scalp.
• The bruises and scrapes will be noted on day 1 or day 2 and disappear by 1 to 2 weeks.
• The fat tissue injury won't be apparent until day 5 to 10. A firm coin-shaped lump, under the skin and sometimes with an overlying scab, is the usual finding. This lump may take 3 or 4 weeks to resolve.
• For any breaks in the skin, apply an antibiotic ointment such as Polysporin (no prescription needed) 4 times per day until healed.
• Call Your Doctor If: it becomes tender to the touch, soft in the center, or looks infected.
5. Milia:
• Milia are tiny white bumps that occur on the faces of 40 percent of newborn babies.
• The nose and cheeks are most often involved, but milia are also seen on the forehead and chin.
• Milia are many in number and occur equally on both sides of the face.
• Although they look like pimples, they are much smaller (pinhead size) and not infected.
• They are blocked-off skin pores and will open up and disappear by 1 to 2 months of age.
• They do not look like water blisters.
• No ointments or creams should be applied to them.
6. Mongolian Spots:
• A Mongolian spot is a normal bluish-green or bluish-gray flat birthmark that is found 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 occur most commonly over the back and buttocks, although they can be present on any part of the body.
• They vary greatly in size and shape.
• They have no relationship to any disease.
• Most fade away by 2 or 3 years of age, although a trace may persist into adult life.
7. Stork Bites (Pink Birthmarks):
• Flat pink birthmarks occur over the bridge of the nose, the eyelids, or the back of the neck ("stork bites") in more than 50 percent of newborns. The ones in front are often referred to as "an angel's kiss".
• 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 persist for a few additional years. Those on the forehead that run from the bridge of the nose up to the hairline usually persist into adult life. Laser treatment during infancy should be considered. Most birthmarks on the nape of the neck also clear, but 25 percent can persist into adult life.
8. Strawberry Hemangiomas:
• Red birthmarks that are raised or increasing in size (strawberry hemangiomas). These usually start after 3 weeks of age.
• They become larger for 1 year, then 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 next regular visit (sooner if concerned).
9. Port-Wine Stain Birthmarks:
• Present at birth in 0.5% of 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

Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 6/1/2011
Last Revised: 8/1/2011
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.

Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 6/1/2011
Last Revised: 8/1/2011
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.