Baby Acne: What It Is, Why It Happens, & How To Care For Your Newborn's Skin

You just brought your baby home, and somewhere around week two or three, you notice it: tiny red bumps scattered across their cheeks, forehead, and chin… baby acne! Baby acne is extremely common and completely benign, and it almost always resolves on its own. 

In this article you'll learn what baby acne is, how to tell baby acne apart from other newborn rashes, what to put on baby acne (and what to avoid), and when it's worth calling the doctor.

Baby acne, medically known as acne neonatorum or neonatal acne, typically appears in the first two to four weeks of life and affects up to 20% of newborns (1). It presents as small red or white bumps, primarily on the cheeks, forehead, and chin, and occasionally on the scalp and neck.

It is worth knowing that what parents commonly call "baby acne" is actually an umbrella term for a few related but distinct skin conditions that can look similar: 

• Neonatal comedonal acne involves the formation of open and closed comedones driven by sebaceous gland activity. 
• Neonatal cephalic pustulosis is a separate but clinically similar condition characterized by pustules without comedones, and is associated with colonization by Malassezia, a yeast that naturally inhabits newborn skin (2). 
• Sebaceous gland hyperplasia - tiny yellowish or flesh-colored bumps across the nose - is another common finding that parents often lump into the "baby acne" category.

For the purposes of this article, we'll use "baby acne" the way most parents do: to describe those early weeks of bumpy, blotchy newborn skin on the face. But I want you to know that all the presentations described above are benign and self-resolving.

You might find this article helpful, too: Baby Skin Care 101

The primary driver of baby acne is hormonal. During pregnancy, maternal androgens cross the placenta and enter the baby's circulation, stimulating the sebaceous glands (oil glands) in the skin (1). The baby's own adrenal glands also produce significant levels of dehydroepiandrosterone (DHEA) during the neonatal period, which further stimulates sebaceous gland activity and increases sebum production (1). In baby boys, testicular androgens add another layer of hormonal stimulation, which may explain why baby acne appears to be slightly more common in boys.

The sebaceous glands in newborns are disproportionately large relative to the rest of the skin, and sebum production peaks in the first week of life before gradually declining (3). As these hormone levels normalize and the adrenal glands mature over the first weeks and months, sebum production naturally decreases and the skin clears.

For neonatal cephalic pustulosis specifically, research has confirmed that Malassezia colonization - which begins at birth and increases in the first weeks of life - plays a role in the pustular component of the presentation (2). Malassezia is a normal part of the skin microbiome, not an infection, and its presence in newborns is universal.

The key takeaway for parents: baby acne is not caused by anything you did or didn't do. It is a normal physiological response to the hormonal transition from womb to world.

You might like this article: Understanding Cradle Cap: Safe Home Care For Your Baby’s Scalp

Baby acne typically presents as (1):

• Small red or pink bumps and pustules on the cheeks, forehead, and chin
• Occasional involvement of the scalp and neck
• No blackheads in most cases, as true comedones are less common than pustules in neonates
• Skin that may look worse when the baby is hot, fussy, or crying, or after contact with saliva, spit-up, or rough fabric

Baby acne generally appears between 2 and 4 weeks of age and resolves on its own within 4 months, most often without any scarring (1).

Want to learn more about acne in teenagers? Check out this article: Managing Teen Acne: A Holistic Approach

Because newborn skin can develop several different types of rashes in the first weeks of life, it helps to know what you're looking at. Conditions sometimes confused with baby acne include:

• Milia - tiny white cysts that look like whiteheads, caused by keratin trapped under the skin; they are very common, completely harmless, and resolve without treatment.
• Erythema toxicum neonatorum - a blotchy, red rash with small white or yellow pustules that affects up to half of all newborns in the first few days of life; it looks dramatic but is entirely benign and self-resolving.
• Eczema - tends to appear later, typically after 2 months, and presents as dry, scaly, itchy patches rather than bumps or pustules; eczema requires different care and management.
• Heat rash (miliaria) - presents as small red bumps caused by blocked sweat ducts, often appearing in skin folds or when the baby is overdressed or in a warm environment.

If you're unsure what you're looking at; your baby's rash is accompanied by fever, seems to be spreading rapidly, or involves blistering; or your baby seems unwell, always check with your pediatrician.

To learn more about eczema in children, read this article: The Atopic March: How Eczema, Food Allergies, Asthma, & Allergies Are Connected

The most important thing to know about baby acne is that less is more. Newborn skin is significantly more permeable and fragile than adult skin, with a thinner stratum corneum and a still-developing skin barrier (4). This means that products, fragrances, and harsh cleansers that might be tolerable on adult skin can easily disrupt the delicate pH and barrier function of a newborn's face.

Research supports keeping newborn skin care simple, gentle, and fragrance-free (4). Here are the evidence-informed principles for caring for baby's skin during a breakout.

Wash gently and infrequently. 

Bathing your baby two to three times per week is sufficient; daily bathing is unnecessary and can dry out the skin (4). When you do wash baby's face, use lukewarm water and a small amount of mild, fragrance-free cleanser designed specifically for newborns. Pat dry gently rather than rubbing. You might like this article: A Guide For Bathing Your Baby

Do not scrub, pick, or squeeze. 

This can irritate the delicate skin barrier, introduce bacteria, and potentially cause scarring. The bumps will resolve on their own.

Avoid applying oils to affected areas. 

Many well-meaning parents reach for coconut oil, olive oil, or thick creams when they see bumps - but applying oils to already-congested pores can worsen the situation. If your baby's skin is dry in areas without active breakouts, a small amount of a gentle, fragrance-free lotion can be appropriate if needed (4).

Keep fabrics soft and clean. 

Rough fabrics and dried spit-up left against the skin can aggravate baby acne. Use soft, breathable clothing and wash baby's clothes and linens in a gentle, fragrance-free detergent.

Avoid fragranced products entirely. 

Fragrance is one of the most common skin irritants in baby skincare products and has no place on a newborn's face. This applies to wipes, lotions, laundry detergents, and any product that contacts your baby's skin (4).

To learn more about toxins in skincare, read this article: 5 Common Toxins In Skin Care Products

Some parents wonder whether what they eat affects their baby's skin through breast milk. While there is limited direct research on maternal diet and neonatal acne specifically, the hormonal mechanism driving baby acne is primarily placental and adrenal in origin rather than dietary, meaning what you eat is unlikely to cause or worsen it. That said, there are certainly cases in which maternal diet can cause allergies in a breasted infant. 

To learn more about low allergen diets for breastfeeding mothers, read this article: Low Allergen Diets: A Guide For Breastfeeding Moms

Given how permeable and sensitive newborn skin is, product selection matters enormously in the early weeks. Research supports keeping newborn skincare simple, gentle, and fragrance-free (4). When choosing skincare for your baby during and after a breakout, look for products that are free from fragrance, harsh surfactants, dyes, and unnecessary additives — all of which can disrupt the delicate pH and barrier function of developing newborn skin.

For everyday cleansing, our Cleanest Care™ Nourishing Shampoo & Body Wash is formulated to be calming and gentle on baby's skin and hair without stripping the skin barrier. For moisturizing areas of dry skin away from active breakouts, our Cleanest Care™ Nourishing Daily Lotion provides plant-powered hydration that nourishes without clogging pores. For soothing dry or irritated patches, our Cleanest Cure™ Dr. Balm is a hypoallergenic, plant-powered balm gentle enough for newborns.

Baby acne is almost always benign and self-resolving, but contact your pediatrician if:

• The rash is present at birth rather than appearing in the first weeks
• The bumps are large, cystic, or nodular
• The rash is spreading rapidly or covers a large area of the body
• Your baby has a fever or seems unwell
• The rash does not resolve by 3 to 4 months of age
• You notice signs of true infection: increasing redness, warmth, swelling, or discharge

Severe or persistent neonatal acne can occasionally indicate an underlying hormonal issue and warrants medical evaluation (1).

Baby acne is one of the most common newborn skin concerns, affecting up to 20% of newborns in the first weeks of life. It is driven primarily by maternal and neonatal androgens that stimulate the sebaceous glands, causing excess sebum production in the still-maturing newborn skin. Malassezia colonization may also contribute to the pustular component. The condition is benign, self-limiting, and resolves without scarring in the vast majority of cases by four months of age. 

Caring for baby's skin during a breakout means keeping things simple: gentle, infrequent cleansing with fragrance-free products, no picking or scrubbing, and avoiding the temptation to apply heavy oils or creams to affected areas. The developing newborn skin barrier is delicate and deserves products formulated with that fragility in mind.

1. Antoniou C, Dessinioti C, Stratigos AJ, Katsambas AD. Clinical and therapeutic approach to childhood acne: an update. Pediatr Dermatol. 2009 Jul-Aug;26(4):373-80. doi: 10.1111/j.1525-1470.2009.00932.x. PMID: 19689511.
2. Bernier V, Weill FX, Hirigoyen V, Elleau C, Feyler A, Labrèze C, Sarlangue J, Chène G, Couprie B, Taïeb A. Skin colonization by Malassezia species in neonates: a prospective study and relationship with neonatal cephalic pustulosis. Arch Dermatol. 2002 Feb;138(2):215-8. doi: 10.1001/archderm.138.2.215. PMID: 11843642.
3. Hoover E, Aslam S, Krishnamurthy K. Physiology, Sebaceous Glands. [Updated 2022 Oct 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499819/ 
4. Stamatas GN, Nikolovski J, Mack MC, Kollias N. Infant skin physiology and development during the first years of life: a review of recent findings based on in vivo studies. Int J Cosmet Sci. 2011 Feb;33(1):17-24. doi: 10.1111/j.1468-2494.2010.00611.x. PMID: 20807257.