There are few things softer and sweeter than a baby’s new skin. So it can be surprising for parents to learn just how many rashes and skin conditions can affect babies! For example, baby eczema, or atopic dermatitis, is more common than not. The National Eczema Association explains: Atopic dermatitis is one of the most common types of eczema, affecting 13% of all children under the age of 18 in the United States. However, baby eczema is not the only skin condition that might appear on our little ones. Here we will go over some other common conditions and how to distinguish them from baby eczema.

Baby Eczema

The National Eczema Association goes on to define atopic dermatitis as a chronic, inflammatory condition that is a result of an overactive immune system response to triggers inside and outside the body.The symptoms of baby eczema are dry, red, very itchy rashes. Once the trigger, be it allergen or irritant, is identified, parents can help manage flare-ups by minimizing their baby’s contact with these triggers, while also maintaining a good daily routine of bathing and moisturizing and using any medications or ointments recommended by their child’s physician. See our article on treatment for more details. Thankfully, most children grow out of baby eczema by the age of five.

Secondary Infections

Unfortunately, many children with baby eczema also suffer from infections. Because the skin is dry, it cracks, allowing bacteria, viruses, and other germs to get in. This can be worsened by excessive itching.How do you know if your baby’s eczema rash has become infected:

1. The usual treatments that help resolve a flare-up won’t work. Either eczema stays the same or gets worse.
2. Eczema will look different. It may have a yellow, orange or honey-colored crusting, blisters and sores, or even streaks of redness.
3. Your baby may also have a fever or flu-like symptoms, other pain, and/or swollen tonsils or lymph nodes.

If your child has flu-like symptoms with a fever over 100.4, they need immediate medical attention. If not, you should still make an appointment with your baby’s physician so they can assess the infection to determine its cause and how to best treat it. They will most likely prescribe an oral antibiotic, antiviral medication, or even an anti-fungal ointment.

Baby Acne

Baby acne is as common as baby eczema. In fact, the American Academy of Dermatologists (AAD) estimates that 20% of newborns have acne.It can be challenging to distinguish between baby acne and baby eczema, as the two often appear in the same areas. But they have definite different characteristics and timelines. For example, baby acne occurs much earlier than baby eczema, and unlike baby eczema, it is not itchy.

Neonatal Acne

Acne that appears at birth or soon after, around 2 - 4 weeks of age, is called neonatal acne. It presents as tiny red or white bumps on the cheeks, nose, and forehead. It typically resolves on its own within 3 - 4 months with no residual marks or scarring.

Infantile Acne

If acne appears after 6 weeks of age this is a different form of acne known as infantile acne. Like teenage or even adult acne, it appears as blackheads, whiteheads, pimples & spots, or even cysts.Infantile acne may also resolve on its own after about 6 months to a year, but it can persist into teenage years. If an outbreak occurs, it’s important to visit your baby’s physician so they can:

• Confirm it truly is acne and not a different skin condition
• Determine if there’s an issue with your baby’s health, as infantile acne can be a symptom of an underlying condition
• Assess if there are any products that may be causing it
• Help prevent scarring

Milia

To further confound us there is then milia which looks an awful lot like baby acne and usually appears in the same locations, as well. It presents as tiny white bumps on a newborn’s cheeks, nose or chin, but it can also appear on their arms and legs. It’s most common in newborns but can affect children of all ages.Milia is caused by dead skin flakes trapped under the skin’s surface. The good news is that it usually goes away without treatment after a few weeks. If it appears on a child over six weeks of age, it’s a good idea to consult with their doctor just to confirm it’s not baby acne.

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Cradle Cap

Cradle Cap is the common name for seborrheic dermatitis, a non-itchy type of eczema. Its colloquial name comes from the fact that it usually first appears on the scalp, but it can also appear on the forehead, face, neck, ears, armpits, diaper area, and in skin folds and creases. Though it looks scaly, yellowish, with crusty patches, and sometimes surrounded by redness, it has not been found to be painful or uncomfortable.Cradle cap develops in babies who are 2 weeks to one year old. Though experts are not entirely sure why they suspect it is a combination of too much oil on the skin from oil glands and hair follicles combined with the presence of a naturally occurring skin yeast called Malassezia.It usually goes away on its own without treatment within a few weeks to a month, but seborrheic dermatitis found in the diaper area or skin folds can be prone to infection, so monitor those areas closely. Infections will be red, oozy, and warm to the touch.

Heat Rash

Many babies will suffer from heat rash, especially those exposed to hot or humid weather. The cause of heat rash is sweat trapped under the skin due to blocked pores. It appears as tiny, red fluid-filled blisters usually on the neck, shoulders, chest, armpits, elbow creases, and grown.Heat rash usually goes away within a few days and can be prevented by helping your baby stay cool and not overdressed.

Diaper Rash

Most parents are already aware of diaper rash and will see it at one time or another. It is caused by wet diapers on sensitive skin, infrequently changed diapers, and/or chafing.It will appear as bright, red skin on the bottom, thighs, or genitals, and the baby will be noticeably uncomfortable, especially during diaper changes, as the skin is very tender to the touch.A little air drying and ointments will help diaper rash heal within a few days.

Erythema Toxicum Neonatorum (ETN)

This is another common and harmless skin condition that tends to appear on newborns within the first couple of days after birth. It appears as small spots or pimples that are 1-4 mm in diameter, mostly on the arms and legs, never on the palms or soles of the feet.Like cradle cap, the cause is not entirely known but it's thought to be related to microbes getting into hair follicles found throughout the body. This isn’t necessarily bad, as experts believe it may be part of how a baby builds up their immune system.It will typically clear up on its own within 5-14 days and without treatment.

The Baby Center provides a wonderful visual guide to all of the conditions described above and more, but nothing beats consulting with your baby’s physician for a diagnosis because, as we’ve learned, many of these conditions are common and can look like each other! In the meantime, keep your baby well moisturized, cool, and dressed in soft, loose clothing. And remember what distinguishes baby eczema from all the other rashes...its itchiness!

Is your baby's skin experiencing a rash or other symptom? Chat with a board-certified pediatrician from Blueberry Pediatrics, today. Blueberry offers text, phone, or video care from board-certified pediatricians 24/7. The best part? An entire year of Blueberry membership costs less than the typical copay of a single urgent care visit, and one membership covers all children in your household - it's like having a doctor's office in your home! Sign up here.