Your baby's skin
Your baby may have some changes in their skin that seem unusual to you. Most skin changes in newborns are fairly common and do not need medical treatment.
- Baby acne is a red, pimply rash on the face. It usually starts when a baby is 2-3 weeks old and disappears within a few weeks. Baby acne can happen from the nipples up, but are mostly on the face. No treatment is needed.
- Cutis marmorata is a condition where the skin looks like pinkish-blue marble in cold temperatures. This is not painful or harmful, and will stop over time.
- Dermal melanocytosis (“Mongolian” spots or slate gray nevi) are flat birthmarks that can be deep brown, slate gray, or blue-black in colour. They sometimes look like bruises and are often found on the lower back and bottom. The spots are present at birth. Most fade (at least somewhat) by age 2 and usually completely by age 5. They are more common in Asian and Black populations.
- Erythema toxicum is a common, splotchy red rash that can affect newborns. Some have firm yellow or white bumps surrounded by a flare of red skin. The rash can come and go on different parts of the body. It’s most common on the second or third day of life, but can appear at birth or within the first 2 weeks. The individual splotches can stay for a few hours, or for up to 8-10 days. There is no treatment – it will gradually disappear.
- Milia are tiny whiteheads on your baby’s face. There is no treatment and they will disappear on their own.
- Vernix is a greasy, white substance that covers and protects your baby’s skin in the uterus. Some babies are born with a lot of vernix still on their skin. It’s harmless and can be washed or wiped off. Losing vernix may cause the skin to peel during the first week of life. This is normal. It will go away on its own, and does not benefit from the use of moisturizing cream.
Caring for the umbilical cord
By the time you are home from the hospital, your baby’s cord will have started to dry. It should fall off within 1 to 3 weeks. Until then, you should keep it clean and dry.
Water is all you need to clean it. Do not pull on the stump, even when it starts to come off. It will fall off on its own. You can prevent your baby’s diaper from rubbing the area by folding it over.
Contact your doctor if your baby has a fever (temperature of 38.0° C or higher) or if the umbilical area:
- appears red and swollen,
- oozes yellow pus,
- produces a foul-smelling discharge, or
- bleeds significantly (a small amount of bleeding is normal and you may find a few spots of blood on the undershirt or sleeper).
Bathing your baby
Bathing your baby is an important part of keeping them healthy, however, you don’t need to bathe your baby every day. A wash with a warm, wet cloth will help keep your baby clean between baths.
Wash your baby’s face and hands often and thoroughly clean the genital area after each diaper change using a warm, wet cloth or unscented baby wipes. You don’t need to use soap, but if you do, make sure it is mild and unscented. Rinse well to prevent skin irritation.
- Bathe your baby in a warm room.
- The water should feel comfortable to the touch.
- Have all of your supplies within reach so that you never leave your baby alone.
- Remove any jewelry that might scratch your baby.
- Hold your baby securely.
- Use clean water to wash your baby’s eyes, ears, mouth and face.
- Wipe female genitals from front to back. Gently wash the vaginal lips.
- Keep the penis clean by gently washing the area. Do not try to pull back the foreskin (usually, it is not fully retractable until 3 to 5 years old, or even until after puberty). Never force it.
- Do not use cotton swabs to clean inside baby’s nose and ears. Mucus or earwax will work itself out in time.
- Pat your baby completely dry with a towel.
- Never leave your baby unattended in a bath, even for a moment.
Diaper rash
Diaper rash – also called diaper dermatitis – happens when your baby’s skin gets irritated from wet or soiled diapers. It can happen if your child has very sensitive skin or when urine or stool in the diaper touches skin for too long, making it sore and red. Click here for more information on treating a diaper rash.
Cradle cap
Cradle cap appears as crusty patches of scaly skin on your baby’s scalp. There may be some redness around the scales. You might also notice redness on other parts of the body, including the folds of the neck, armpits, behind the ears, on the face and in the diaper area. This is called seborrheic dermatitis.
How should cradle cap be treated?
Cradle cap will go away on its own and does not need to be treated. If you want, you can wash the hair with a mild baby shampoo and gently brush out the scales with a soft bristled brush to help control it. However, shampooing your baby’s hair too often will also cause dry scalp.
Baby oil or mineral oil may help soften the scales. When applying the oil, rub only small amounts into the scales. Then shampoo and brush out the oil about an hour later to avoid more build-up.
If your baby has dry, scaling, thickened skin over the forehead, cheeks and behind the ears, this is called seborrheic dermatitis. An unscented moisturizer can be used 2 to 3 times a day on the skin. A mild hydrocortisone cream (0.5%) is safe and usually effective. If this doesn’t help, see your health care provider. This will usually improve by 4 months of age.
Eczema
Eczema is a skin rash that shows up as dry, thickened, scaly or rough skin, or tiny red bumps that can blister, ooze, or become infected. The rash is often itchy.
Eczema usually appears on a baby’s forehead, cheeks or scalp, though it can spread to the arms, legs, chest or other parts of the body. Often — though not always — it occurs in babies who have allergies or a family history of allergy or eczema.
How should eczema be treated?
Although there is no cure for eczema, it can usually be controlled and often will go away after several months or years.
- Daily warm baths, letting your baby soak can help. After a bath, pat your baby’s skin dry (do not rub) and apply an unscented moisturizer to trap water in the skin.
- Use a gentle, unscented moisturizer instead of a lotion on your baby’s skin to reduce dryness. Moisturizers are usually heavier/thicker. They help retain moisture in the skin. You can use it 2 to 3 times a day. Petroleum jelly is a great moisturizer.
- Dress your baby in loose cotton fabrics. Avoid wool. Long sleeves and pants can help keep moisturizers from being rubbed off and can help prevent scratching.
- If the rash persists and your baby is not comfortable, your health care provider may consider medication.
Contact dermatitis
Contact dermatitis can develop after your baby’s skin touches something irritating or that they are allergic to. For example, laundry detergents, dyes in clothing, or metallic snaps on undershirts.
These may cause rashes in areas where the clothing rubs or where there is sweat. Contact dermatitis rash is usually only found on the part of the skin that came in contact with the item your baby is allergic to.
The treatment is the same as for eczema but your health care provider may want to find the cause of the rash by asking if there is anything new or different your baby came into contact with.
Heat rash
Heat rash causes little bumps on the skin when your baby overheats. The bumps may be red, especially in babies with light skin color. You can usually see it in the folds of baby’s skin and on parts of the body where clothing fits snugly, including the chest, stomach, neck, groin and buttocks.
Hot, humid weather promotes heat rashes, but it can happen in the winter if your baby has too many layers of clothing.
Remove any excess clothing. Keep your baby comfortably cool by dressing them in loose-fitting, light cotton clothing, especially in warm, humid weather. The rash will go away on its own.
Reviewed by the following CPS committees
- Community Paediatrics Committee
Last updated: July 2022