What’s THAT? Musings on Newborn Rashes

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While that’s true, newborn rashes are a fact of life. While you absolutely want to contact your baby’s healthcare provider for any rash that concerns you, there are a number of rashes that are very common. It’s worth talking about some of the ones we see more often. Most are benign, but not all; we’ll discuss some, uh, red flags as to when to seek attention sooner.

Benign rashes: The “All the Time” Stuff

A lot of parents are surprised when their little one develops rashes or bumps. After all, none of those babies in the baby ads have a thing! (Babies in ads actually wear makeup.) On the other hand, most pediatricians find it unusual, though not necessarily concerning, if a baby doesn’t have anything going on with her skin. Space doesn’t permit discussing every possible benign rash, but here are a few that a busy practice would likely see a few times a day:

  • Erythema toxicum, despite its horrible-sounding name, is a benign rash. It shows up at a few days of age as round, pink, slightly raised blotches, usually with small, raised, white centers. They go away in a few weeks without treatment.
  • Baby acne shows up at a few weeks of age. The small red bumps resemble a miniature version of the familiar teen condition. Unlike teen acne, however, there’s general agreement that this doesn’t need to be treated, as it goes away on its own in a few months.
  • Seborrhea can bear a slight resemblance to baby acne. Usually, though, it has a little more of a scaly appearance and is closer to the scalp line, especially near the ears. Often a baby will also have “cradle cap,” a scaly rash on the scalp. This is usually treated with certain types of shampoo (sometimes just a baby oil in mild cases).
  • A heat rash can look similar as well. Usually the bumps are smaller, and they often spread to the chest. Again, no treatment is necessary.
  • Birthmarks can have a variety of appearances. What they have in common is that they are groups of blood vessels that become visible. The quickest to go away, commonly called “salmon patches,” are light pink and flat. If darker and purplish, they may be “port wine stains,” which don’t go away as readily and often need treatment. Finally, “strawberry marks” are raised, reddish bumps that develop after birth, grow through infancy, and then usually resolve on their own. Only a minority of these need treatment.

Seek Help: Or, Blanching Isn’t Just for Vegetables

Again, space doesn’t allow discussion of every rash that could signify a problem. But let’s talk about a few that may be more concerning:

  • A rash consisting of dark purple spots that don’t fade of “blanch” when the area is pressed may be worth an emergent visit for a couple of reasons. If the baby appears ill, this type of rash can signify a serious bacterial infection. Healthy-appearing babies may have a problem with their platelets, or clotting cells. It’s worth asking your baby’s provider to demonstrate blanching at the next visit, since this is easier than describing it.
  • Raised red bumps that are in clusters may signify an infection with the herpes virus. This, of course, would be particularly worrisome if the mother had herpes around the time of delivery. Since herpes can make a young infant much sicker than a healthy older person, this is worth a call if it’s a possibility.
  • Although we don’t see this as often anymore, chickenpox consists of big, fluid-filled bumps. It’s a problem in particular if the mother got the disease right around the time of delivery; this is another case where newborns become much sicker. Fortunately in this era of immunization, we don’t see it that often, but it’s worth being aware of it, particularly if you’re not immunized.

When to Call

Chances are, your baby will be seeing a provider with enough frequency that rashes that don’t fit the “concerning” description and don’t seem to be bothering the baby can be addressed at visits. But in addition to the above signs, a call is warranted for any infant that appears ill with the rash. So if he’s not feeding well, or has a fever, or even if he “just doesn’t look right,” seek immediate medical attention! It’s also important to be aware of any medical conditions or infections you might have or have had that might be passed on to the baby. Otherwise, knowing that most newborn rashes will go away on their own might help you focus on the joys of face-to-face interaction with your little one!

Stan Sack
Dr. Stan Sack has 29 years’ experience as a primary care pediatrician in Massachusetts and Florida. A medical writer since 2015, he enjoys blogging on topics that are on parents’ minds but are covered less often in books and on websites. He lives in the Florida Keys with his family and enjoys healthy cooking, fitness activities and singing in his spare time.

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