Newborn Infant Skin Rash Syndromes and Birthmarks

This page contains information about common infant skin rash syndromes such as birthmarks and rashes that occur in the first few weeks of life. There are great photos as well, so read on.

To read about rashes in older babies and toddlersclick here

  • Erythema Toxicum - a red rash with a raised spot in centre (red or sometimes white) over the whole body seen in newborn babies in the first few days. Read more
  • Milia - white spots mainly on the face -read more
  • Miliaria - also known as prickly heat, this causes a red rash on the body - read more
  • Neonatal Acne - these red spots that look like acne occur in between the 2nd and 4th week of life - read more
  • Mongolian Blue Spot - this looks like a bruise but is actually a birthmark - read more
  • Salmon Patch or Stork Mark - this birthmark is usually on forehead or back of the neck - read more
  • Strawberry Hemangioma (or Nevus) - this is a bright red birthmark that is often raised and gets bigger in the first few months - read more
  • Cradle Cap - this is a common condition where babies have a greasy yellow "dandruff". Read more
  • Sebaceous nevus - this is an uncommon condition where babies have a warty growth on the head which is usually noticed at birth. Read more

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Erythema Toxicum

This is a common benign skin rash in babies and occurs often by day 2 or 3 of life and up to 2 weeks of age. This infant skin rash doesn't cause the baby any distress.

Erythema toxicumErythema toxicum
Close upClose up

The rash consists of spots, (raised to touch) which may be red or white, surrounded by redness - the white spot looks a bit like a white head pimple surrounded by a red area.

The spots occur all over the body (but not the palms of the hands or soles of the feet) and can come and go within hours only to appear somewhere else on the body.

No treatment is required as the rash will disappear by itself after a few days but they can come back over the first few weeks.

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Milia

miliaMilk spots

These are little white spots that babies get on their faces particularly around the nose and chin - they look like little pimples and are often called "milk spots" because they are so common in newborn babies in the first week.

They are caused by trapping of dead cells under the top layer of the skin. If your baby gets one of these on the hard palate, it is referred to as an Epstein Pearl. No treatment is needed. Do not squeeze milia or apply creams. This common infant skin rash will go away by itself.

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Miliaria

prickly heat babyMiliaria

This is also known as prickly heat. The rash is red and there can be small blisters. It usually occurs on the face or on the body under clothes. It is caused by a blockage to sweat glands and is more common in a warm, humid climate. It can be seen over the first few weeks of life and later in life.

In the first few weeks, there are often little superficial blisters, miliaria crystallina, but later in life, it is deeper little red lumps, miliaria rubra. Read more

No treatment other than cooling is required. Cooling can be achieved by placing a cool (not cold) flannel on the body where the spots are for no more than 10 minutes at a time. If the spots are under clothes, change to looser, cooler clothing. Cotton clothing is cooler generally than synthetic materials. No other treatment is required.

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Neonatal Acne

neonatal acneNeonatal acne

Neonatal acne is a benign condition that occurs in babies under a month old. It may involve the face, chest, back and groin areas.

Neonatal acne consists of red spots that then become pustular (like a pimple head). They usually occur between 2 and 4 weeks of age. Some babies may have the spots until about 8 months of age.

Neonatal acne resolves by itself so no treatment is required in most cases. In severe cases, a ketoconazole 2% cream can be used twice daily (or alternatively, 2.5% benzoyl peroxide gel can be used). Babies with severe forms of neonatal acne are more likely to have adult acne, but most babies with neonatal acne will not have acne later in life.

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Mongolian Blue Spots



Mongolian blue spotMongolian blue spot
ShoulderShoulder



Mongolian spotsButtock

These are blue spots that look a lot like bruises and are usually located at the base of the spine or over the buttocks but can be anywhere. This infant skin rash syndrome is more common in babies of African-American, Afro-Caribbean or Asian ethnicity.

The blue spots don't cause any pain and will eventually fade by themselves. No treatment is required.

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Stork Marks or Salmon Patches (Capillary Hemangioma)

These are pink / red marks often on the forehead between the eyes and on the nape of the neck. They are not raised. They are very common. They fade over the first year of life although they can become more prominent with crying.

salmon patch foreheadForehead patch
salmon patch neckNeck patch

The patches on the neck may stay for longer than a year but they will be covered with hair eventually and are not a problem. This is quite a common infant skin rash syndrome.

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Strawberry Hemangioma

Also known as strawberry nevus and cavernous hemangioma.

strawberry nevus babyStrawberry nevus
strawberry haemangioma
strawberry hemangiomaHemangioma with strawberry top

This common infant skin rash syndrome is usually present at birth or very shortly after birth. It will probably start as a small bright red spot. The spot gets progressively larger over the first few months of life and looks like a strawberry. By 12 months of age, the strawberry is starting to shrink in size and it will have usually disappeared completely by 5 years of age.

No treatment is usually required for this infant skin rash which will eventually disappear by itself. If the strawberry is knocked, it can bleed - just apply firm pressure until the bleeding stops.

Sometimes there will be a hemangioma that is completely below the surface of the skin - in these cases, there will be a swelling that is soft to touch and the hemangioma will give a blue tinge to the skin. Occasionally such a swelling will have a strawberry on top like the 2 lower photos. This type of hemangioma is also likely to shrink in size.

Occasionally strawberry hemangiomas are in places that interfere with normal life - around the eye, around the mouth and neck. In those cases, treatment will be required.

Recently, studies have shown that treatment with Propanolol (a drug usually used to lower blood pressure) can shrink strawberry nevi. This drug is usually started in low doses with monitoring of the blood pressure. This is a good option for strawberry nevi that are in locations that interfere with normal function, eg. near the eye or interfering with the airway.

Other treatments for hemangiomas include laser and oral steroids.

Remember, a strawberry hemangioma gets bigger before it starts to shrink. This is a commonly seen infant skin rash.

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Cradle cap

Cradle capCradle cap

Cradle cap is a type of seborrheic dermatitis that is frequently seen in babies. It causes no distress to them but parents often find it distressing because of the way it looks. You can put a hat on your baby to hide cradle cap or you can gently remove after softening with olive oil. In severe cases, an antifungal shampoo can be used. Read more.

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Sebaceous nevus

Sebaceous nevusSebaceous nevus

A sebaceous nevus is a hairless patch on the scalp or there is a velvety tan or orange patch on the scalp. It occurs in 3:1000 babies. In early life, there are no problems and they are eventually covered as the hair grows around them. However, they need to be removed sometime before puberty as some of these (10-15%) can become cancerous later in life.

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Last reviewed 20 September 2011

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Dr Maud MD

Dr Maud MD (MBChB, FRACP, FRCPCH), a specialist pediatrician, provides health information and medical advice for parents of babies and toddlers. Read more about Dr Maud.



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