Doctors’ Notes
BackYour Newborn’s Skin
Your Newborn’s Skin
Some of the most frequently asked questions we hear from new parents are about their baby’s skin. Here’s some information to help…
Differences Between Adult & Newborn Skin
A newborn’s skin is different from an adult’s skin in a couple of ways. It has a higher water content and is able both to absorb more water and, conversely, to lose excess water faster that adult skin. A baby’s skin also allows more things to penetrate more easily. Sweat glands are fewer in the newborn. Their skin grows and heals faster.
Another difference is that a newborns’ ability to regulate their body temperature is not fully developed, so they’re not able to increase their temperature to stay warm, nor can they cool themselves as well. A good rule of thumb is to dress your newborn in one more layer than you would dress yourself in colder weather, and to avoid overdressing in warmer weather.
Common Findings of Newborn Skin
ACROCYANOSIS
You may notice that your newborn’s hands and feet feel cooler and have a bluish color to them. This is because the blood vessels leading to these areas are more responsive to colder temperatures and actually shrink, which decreases the blood flow to these areas. Moving the arms and legs should quickly change the color to pink. The rest of the newborn’s body and face should be pink.
ERYTHEMA TOXICUM
This sounds a lot more serious than it is. Erythema toxicum is a very common rash in the newborn which looks like red blotches with irregular borders. The rash is slightly raised and may have a small white or yellow dot in the center. It can appear and disappear quickly on different areas of the body. No treatment is necessary, and it resolves after a few weeks.
PEELING, DRY SKIN
Most newborns have skin that appears dry and sometimes peels. It is not necessary to apply lotions or creams to the skin, but it can be helpful especially on areas like the ankles and wrists that may crack. Always use a scent-free, dye-free lotion.
BABY ACNE
This rash appears as pink pimples on the face and sometimes the scalp. Thought to be the result of maternal hormones that stimulate the oil glands. It most commonly occurs during the fourth or fifth week of life. It sometimes gets worse before it gets better and can last for a few weeks. Treatment is usually not necessary. Neonatal acne is not the same acne that older children and adults get.
MILIA
These are tiny white pimples usually found on the nose, but they can also be found on the face. These pimples are due to clogged oil glands and will resolve without treatment.
SALMON PATCHES, or Nevus Simplex
These areas are also called “stork bites” if located at the back of the neck, or “angel kisses” if located between the eyebrows. They are believed to be a collection of blood vessels that usually fade after several weeks or months. Approximately fifty percent of the stork bites at the back of the neck persist for life and generally are not a problem, because hair covers the area.
CONGENITAL DERMAL MELANOSIS
These flat, gray-blue spots are very common on any part of the body, but most commonly the buttocks. They appear very similar to a bruise. They are more common in babies with darker skin or certain ethnic groups. By school age, they usually fade away.
CRADLE CAP (Seborrhea Capitus)
Thick, greasy yellow crusts on the scalp are characteristic of cradle cap, which presents around 1-2 months of age. In addition to these scaly areas on the scalp, occasionally a red, irritating rash may be present on the face, behind the ears and on the neck. To remove these crusts, you can rub some olive oil on the scalp to soften the crusts, and then brush with a soft brush. Prescription medication and shampoo is sometimes needed to treat seborrhea.
Rashes associated with other symptoms such as fever, poor feeding, lethargy, or appear to contain white or yellow fluid need to be evaluated by a provider.
Tips on Skin Care Products for Newborns
When choosing skin care products for your newborn, look for mild skin cleansers and moisturizers that have a good safety/tolerance profile and have been shown to be safe for infants. The first ingredient listed on the product label should be water. They also should not cause eye irritation. Products advertised as being natural are not always better, as some herbs and natural products can be quite irritating.
Newborns do not need frequent bathing, especially if they don’t enjoy it. Once or twice a week is fine to start with. Once they enjoy bathtime, it’s ok to make it part of their daily routine, but remember, using soap frequently can dry out their skin, so consider applying a lotion after bathtime.
As always, if you have further questions about your baby’s skin, please reach out!
Terri Bailey, a Kids Plus Provider since 2011, is a Certified Registered Nurse Practitioner.