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Conditions We Treat

Newborn Rash

At Livingstone Dermatology, we understand that your skin is a reflection of your health and well-being. We are committed to the latest advancements in dermatological science, and dedicated to providing you with quality care.

Overview

It is normal for parents to be concerned about newborn rashes. However, many of these rashes are harmless and improve on their own.

These skin conditions can appear within the first weeks of life, and can last anywhere between several weeks to months, depending on the diagnosis. It is important to understand these common skin conditions and how to effectively treat and manage them.

What are newborn rashes?

Newborn rashes are skin changes that appear on a baby’s delicate skin. These can manifest as red patches, bumps, or dry areas, appearing suddenly after a few days following the baby’s birth, or gradually over time.

Newborn rashes can occur on various parts of the body, including:

  • Armpits
  • Back
  • Cheeks
  • Chest
  • Diaper area
  • Face
  • Forehead
  • Folds, like the neck, behind the elbows, and knees
  • Scalp

Types of newborn rashes

When it comes to newborn rashes, each rash varies in appearance, cause, and treatments. Some of the common types of newborn rashes include:

  • Baby acne: baby acne often appears as small red, or white bumps on the cheeks, chin, and forehead. These bumps typically clear up on their own within a few weeks.
  • Diaper rash: diaper rashes are red, inflamed skin on the diaper area that are occasionally accompanied by small bumps, or peeling skin. It is often due to excess moisture, friction, or certain irritants or allergens.
  • Cradle cap: cradle caps are yellowish, greasy, and scaly patches that occur on the scalp. Although they usually resolve without treatment, provided it is managed with gentle cleansing.
  • Heat rash: heat rashes are tiny red bumps that form on the neck, back, or folds of the skin due to blocked sweat glands.
  • Eczema: eczemas are dry, and itchy patches that can appear on the face, arms, and legs. However, it is more common among newborns with a family history of allergies, or asthma.
Cradle cap is a common type of newborn rash that occurs when the newborn’s sebaceous gland produces too much oil.
  • Erythema toxicum rash: erythema toxicum rashes are the most common yet harmless newborn rash, characterised by red blotches that may have a white, or yellow centre. These rashes often resolve naturally without treatment.
  • Milia: milia are small white bumps that are often developed on the nose, cheeks, or chin. They are caused by trapped skin flakes, and usually clear up within a few weeks.
  • Hives: hives are raised, itchy welts that can appear anywhere on the body due to an allergic reaction, or infection.
  • Transient neonatal pustular melanosis: transient neonatal pustular melanosis are pustules that burst, and leave dark spots, primarily seen in babies with darker skin tones. However, they often resolve on their own without treatment.

What causes newborn rash?

Newborn rashes can be triggered by a multitude of factors, often relating to a baby’s sensitive skin, and developing immune system. While many rashes are harmless, and resolve on their own, understanding the potential causes can help parents manage, and prevent flare-ups. Additionally, it also aids parents in determining when these rashes warrant a medical examination.

Some of the potential causes of newborn rashes are:

  • Genetic predisposition: certain skin conditions like eczema may have a genetic component. Babies with a family history of eczema, asthma, or allergies are more prone to developing atopic dermatitis.
  • Hormonal changes: babies can develop rashes due to hormonal fluctuations after birth. For example, baby acne is believed to be caused by maternal hormones passed to the baby during pregnancy, leading to temporary overstimulation of the baby’s sebaceous glands.
  • Immature skin barrier: newborn skin is delicate, and not fully developed, making it prone to infection, and inflammation. The skin barrier is thinner compared to adults, thereby allowing irritants (such as harsh detergents, and soaps), bacteria, and allergens to penetrate more easily. This subsequently leads to rashes.
  • Overactive immune response: a newborn’s immune system is still adjusting to the external environment. As a result, the immune system may overreact to harmless substance, resulting in rashes such as hives, and erythema toxicum.
  • Microbial infections: newborns have an underdeveloped mircrobiome, making them more susceptible to infection-induced rashes, such as cradle cap, diaper rash, and transient neonatal pustular melanosis.
  • Heat, and friction: newborns can easily become overheated due to their underdeveloped, or blocked sweat glands, leading to heat rash. In fact, areas where skin rubs against skin, such as the neck, or armpits, are more prone to irritation, and rashes.

What are the symptoms of newborn rash?

The symptoms of newborn rashes vary depending on the type, with the high possibility of overlapping. Below are some of the common symptoms that parents should be mindful of:

Baby acne

Baby acne usually develops within the first few weeks after birth, while exhibiting the following symptoms:

  • Red, and white raised bumps on the cheeks, forehead, or nose.
  • Mild redness around the bumps.
  • No itching, or pain associated with the bumps.

Diaper rashes are fairly common, and exhibit the following symptoms:

  • Red, inflamed patches on the buttocks, thighs, and genital area.
  • Dry, scaly, or shiny appearance.
  • Raised red bumps, or blisters (severe cases).
  • Discomfort, especially during diaper changes, or delayed diaper changes.

Tip: To avoid diaper rashes, allow the diaper to breathe as much as possible and change the diapers promptly once they’re wet. After cleansing the affected area with a warm cloth, apply a zinc oxide cream to protect the skin and has mild antiseptic and anti-inflammatory effects.

Cradle cap is a non-contagious skin condition that is linked to an overproduction of oil in your baby’s scalp. A newborn is most likely to have cradle cap if she or he has the symptoms below:

  • Yellowish, greasy scales, or crusts on the scalp.
  • Flaky patches that may extend to the ears, eyebrows, or nose.
  • Does not cause discomfort, or itchiness.

Tip: Use coconut, olive or baby oil to gently massage and dislodge some of the flakes on your newborn’s scalp. Wash away afterwards with a gentle shampoo.

Heat rashes are developed when sweat gets trapped under the skin, triggered by blocked sweat glands. These rashes have the following symptoms:

  • Small, red, or clear fluid-filled bumps, usually on the neck, chest, and back.
  • Itching, or prickly sensation.
  • Skin feels warm to the touch.
heat rash newborns.
Heat rashes are more common among newborns that reside in tropical, and humid climate.

Eczema

Although eczema is commonly associated with genetics, it can be triggered by irritants or allergens. Eczema usually has symptoms, such as:

  • Itchy, red patches, especially on the cheeks, arms, and legs.
  • Dry, cracked skin that may ooze, or crust.
  • Bumps or blisters that may burst, or crust over.

Similar to baby acne, erythema toxicum rashes often appear within the first few days post-birth. The symptoms include:

  • Red blotches with small white, or yellowish bumps in the centre.
  • Commonly found on the face, chest, and limbs.
  • Does not cause itching, or discomfort.

Milia are tiny white, or yellowish bumps that usually develop on a newborn’s face, particularly around the nose, cheeks, and chin. They are typically caused by trapped keratin under the skin surface, and may show these symptoms:

  • Small, white, or yellowish bumps with less than 2mm in size.
  • Often found on the face, but can occur anywhere.
  • No redness, itching, or pain.
  • The skin around the bumps appears normal.

As the glands on your newborn’s skin will open up in the coming days and weeks, the milia will disappear. No treatment is required.

Meanwhile, hives in newborns are often a result of an allergic reaction, which can be triggered by a multitude of reasons. They can be distinguished by looking for the following symptoms:

  • Raised, bumpy welts of various shapes, and sizes.
  • Red, or skin-coloured welts that may change shape, and move around the body.
  • Itching.
  • Swelling, especially around the eyes, lips, and cheeks.
  • Welts may appear suddenly, disappear, and reappear over several hours, or days.

Newborns with darker skin tones are likely to be experiencing transient neonatal pustular melanosis if they exhibit the symptoms below:

  • Small pustules filled with clear fluid, typically developing on the face, neck, back, and limbs.
  • Once these pustules rupture, they leave behind dark spots with a surrounding white scale.
  • The hyperpigmented spots may last for a couple of weeks to months.
  • Does not cause itching, pain, or discomfort.
what is hives
Hives are often triggered by allergens, or irritants that come, and go for several hours, or days.

When should I be worried about my newborn’s rash?

Generally, newborn rashes are normal and will resolve on their own. However, your little one’s rash may require medical attention if you observe the following signs and symptoms:

  • Spreading or worsening rashes
  • Blisters or pus
  • Rashes accompanied by high fever
  • Irritability or unexplained crying
  • Signs of swelling or change in colour
  • Rashes that do not improve
  • Difficulty breathing

How are newborn rash diagnosed in Singapore?

Unfortunately, newborn rashes are typically diagnosed through a physical examination by a qualified dermatologist, with a thorough assessment of the newborn’s medical history.

  • Physical examination: during a physical examination, our experienced dermatologist will examine the colour, size, texture, and presence of the rashes.
  • Medical history: by obtaining a comprehensive understanding of the newborns’ medical history, our dermatologist will be able to determine the potential causes of the rashes.
  • Skin swabs: although rare, our dermatologist may insist on a skin swab to determine, or rule out infections.


To help with the diagnostic process, it is advisable for parents to be mindful of:

  • When did the rashes start?
  • Where are the rashes located on the body?
  • Have the rashes spread elsewhere?
  • Do the rashes worsen when exposed to sunlight, changes in temperature, or during bathing?
  • What are some of the common allergens, and irritants that the newborn is exposed to?
  • What type of soaps, and detergents are used at home?
  • Is the newborn taking any medications, or antibiotics?
  • Does the newborn have a family history of eczema, allergies, asthma, or skin conditions?

How are newborn rash treated in Singapore?

Once our dermatologist has come to a conclusive diagnosis, they will recommend a treatment plan to effectively manage the rashes. Intervention may be recommended to prevent the rashes from exacerbating, or reduce discomfort.

Some of the common treatment measures are:

  • Baby acne, and milia: typically, do not require treatment, and will clear up naturally.
  • Diaper rash: on top of applying zinc oxide directly on the affected areas, it is important to keep the area dry by frequently changing the diapers – ideally every two hours.
  • Cradle cap: gentle washing with a mild shampoo, and soft brushing.
  • Heat rash: dressing the newborn in loose, breathable clothing, and keeping the skin cool through sponging, or regular wiping.
  • Eczema: while applying moisturisers in the affected areas is often enough, severe cases may require topical steroids.
  • Hives: avoiding known allergens, and applying cool compresses to reduce itchiness, and swelling. However, in severe cases, our dermatologists may prescribe antihistamines.
  • Erythema toxicum, and transient neonatal pustular melanosis: usually resolve on their own without treatment.
Most newborn rashes clear up naturally without treatment, however in severe cases, a dermatologist may recommend applying moisturiser or topical steroids to manage the rashes.

Conclusion

At Livingstone Dermatology, we understand, and empathise with new parents who are anxious, and concerned about their newborns’ health and well-being. No issue is too small, and it’s always best to get professional opinion for your baby’s health and your peace of mind. Book a consultation for a detailed assessment and personalised treatment plan.

Frequently Asked Questions

How common are newborn rashes?

Newborn rashes are extremely common, affecting most newborns at some point during the first few weeks, or months of life. As a newborn’s skin is still adjusting to the outside environment, it is more sensitive, and prone to rashes.

While some newborn rashes are unavoidable due to the newborn’s sensitive skin, and adapting immune system, parents can minimise their occurrence by practicing good skincare, and hygiene. This includes using gentle, and fragrance-free products, avoiding overdressing the newborn to prevent sweating, keeping the skin moisturised, and regularly changing wet diapers.
However, rashes that are hormone-induced, such as erythema toxicum rash, are not preventable.

Newborn rashes are typically temporary, and may come and go. On the other hand, birthmarks are usually present at birth, or appear shortly after birth, and are more permanent.
Rashes can appear as red, raised, or inflamed spots, and are often caused by irritation, allergies, or infections. In contrast, birthmarks, such as port-wine stains, and hemangiomas, are areas of skin discolouration that are usually harmless. Additionally, they do not change much in appearance over time.

The duration of newborn rashes can vary depending on their type. While most newborn rashes clear up within a couple of weeks, some may last for several months.

Most newborn rashes are benign, and self-limiting. However, if a rash is associated with other symptoms such as fever, fussiness, poor feeding or latching, appears infected (oozing with pus), it may indicate a more serious condition.
In the event parents notice these symptoms, then we encourage you to seek medical attention immediately.

Some of the warning signs that parents should take note of are:

  • A rash that spreads rapidly, or looks like bruising.
  • Rashes that are accompanied by a high fever (above 38C).
  • Swelling, blisters, or pus.
  • The baby is excessively fussy, lethargic, or refuses to eat.
  • Difficulty breathing.
  • Signs of an allergic reaction, such as face swelling.

If any of these symptoms are present, then do seek medical help immediately.

Yes, there are. Some of the home remedies that parents may try to practice include, but are not limited to:

  • Applying zinc oxide cream on irritated areas to prevent, and soothe the skin.
  • Choosing fragrance-free moisturiser, and wipes.
  • Dressing your newborn in light clothing to prevent heat rashes.
  • Gently bathe your newborn with warm water, and mild, fragrance-free soap.

Ready to take the first step towards understanding and managing newborn rash?

Schedule a consultation with Livingstone Dermatology today.
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