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After the first bath your newborn will normally have a ruddy
complexion due to the extra high count of red blood cells. He can
quickly change to a pale- or mottled-blue color if he becomes
cold, so keep him warm. During the second week of life, your
baby's skin will normally become dry and flaky. Many babies also
get rashes or have birthmarks. In this handout, seven kinds of
rashes and birthmarks are covered.
More than 30% of newborns develop acne of the face: mainly
small, red bumps. This neonatal acne begins at 3 to 4 weeks of
age and lasts until 4 to 6 months of age. The cause appears to
be the transfer of maternal androgens (hormones) just prior to
birth. Since it is temporary, no treatment is necessary. Baby
oil or ointments will just make it worse.
Most babies have a rash on the chin or cheeks that comes and
goes. Often, this rash is caused by contact with food and acid
that have been spit up from the stomach. Rinse your baby's
face with water after all feedings or spitting up.
Other temporary rashes on the face are heat rashes in areas
held against the mother's skin during nursing (especially in
the summertime). Change your baby's position more frequently
and put a cool washcloth on the area that has a rash.
No baby has perfect skin. The babies in advertisements wear
More than 50% of babies get a rash called erythema toxicum on
the second or third day of life. The rash is composed of
1/2-to 1-inch-size red blotches with a little white or yellow
pimple in the center. They look like insect bites. They are
numerous, keep recurring for a week, and can be anywhere on
the body (except palms and soles). The cause of this rash is
unknown and it is harmless. The rash usually disappears by the
time an infant is 2 weeks old, but sometimes not until a child
is 4 weeks old.
If your baby's delivery was difficult, a forceps may have been
used to help him through the birth canal. The pressure of the
forceps on the skin can leave bruises or scrapes or can even
damage fat tissue anywhere on the head or face.
Pressure from the birth canal can damage the skin overlying
bony prominences (such as the sides of the skull) even without
a forceps delivery. Fetal monitors can also cause scrapes and
scabs on the scalp.
You will notice the bruises and scrapes 1 or 2 days after
birth. They will disappear in 1 to 2 weeks.
Injury to fat tissue won't be apparent until the fifth or
sixth day after birth. A thickened lump of skin with an
overlying scab is what you usually see. This may take 3 or 4
weeks to heal. For any breaks in the skin, apply an antibiotic
ointment (OTC) until healed. If it becomes tender to the touch
or soft in the center or shows other signs of infection, call
your healthcare provider.
Milia are tiny white bumps that occur on the faces of 40% of
newborn babies. The nose and cheeks are most often involved,
but milia are also seen on the forehead and chin. Although
they look like pimples, they are smaller and not infected.
They are blocked-off skin pores and will open up and disappear
by 1 to 2 months of age. Do not apply ointments or creams to
Any true blisters (little bumps containing clear fluid) or
pimples (little bumps containing pus) that occur during the
first month of life (especially on the scalp) must be examined
and diagnosed quickly. If they are caused by the herpesvirus,
they must be treated right away. If you suspect blisters or
pimples, call your child's healthcare provider immediately.
A Mongolian spot is a bluish-gray, flat birthmark that is
found in more than 90% of American Indian, Asian, Hispanic,
and black babies. 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. Most fade away by 2
or 3 years of age, although a trace may persist into adult
Flat pink birthmarks (also called capillary hemangiomas) occur
over the bridge of the nose, the eyelids, or the back of the
neck in more than 50% of newborns. Most of these spots fade
and disappear, but some can persist into adult life. 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.