The Bottom Line

Neonatal acne is very common — it affects up to 40% of newborns. It is caused by hormones passed from mother to baby before birth and is not a sign of poor hygiene, illness, or anything you did wrong. The pimples usually appear in the first 2 to 4 weeks of life and clear up on their own by 3 to 4 months without any treatment. Your baby does not need acne products, and the breakouts will not leave scars.

What Is Neonatal Acne?

Neonatal acne is the name for pimples and blackheads that appear on a newborn's skin in the first few weeks of life. It is one of the most common newborn skin conditions, affecting 20 to 40% of babies. Boys are slightly more affected than girls.

The acne usually shows up on the cheeks, forehead, chin, and sometimes the chest. It tends to peak around 2 to 4 weeks of age and then gradually fades on its own. By 3 to 4 months, the skin has cleared in about 90% of babies.

Despite the name, neonatal acne is not the same as teenage acne. It is a normal, temporary response to hormonal changes at birth — and it does not predict whether your child will have acne as a teenager.

Signs and Symptoms

Neonatal acne typically looks like:

  • Small whiteheads or blackheads on the cheeks, nose, forehead, or chin
  • Occasional small red bumps or tiny pustules (about 20% of babies develop these)
  • Mild oiliness or slight shininess to the skin

The skin is not painful or itchy to your baby. The breakouts are usually not angry or inflamed-looking. If the skin looks very red, swollen, or the baby seems uncomfortable, check with your pediatrician to rule out other causes.

What Causes Neonatal Acne?

Before birth, your baby is exposed to your hormones — particularly androgens (male-type hormones) — through the placenta. These hormones stimulate the baby's oil glands, causing them to become temporarily overactive. After birth, as those maternal hormones gradually leave your baby's system over the first few weeks, the oil glands settle down and the acne fades.

Neonatal acne is not caused by:

  • Dirty skin or infrequent bathing
  • Breastfeeding or formula feeding
  • Any product you are using on your baby
  • An allergy or infection

Treatment Options

Watchful waiting (the best approach for most babies): Because neonatal acne clears on its own without treatment in 80 to 90% of cases, the main recommendation is patience. No creams, acne washes, or medications are needed.

Gentle skin care: Wash your baby's face once or twice a day with warm water and a mild, fragrance-free cleanser. Pat dry gently. Do not scrub, squeeze, or pick at the pimples. Avoid applying oils, thick creams, or any adult acne products to your baby's skin — these can clog pores and make things worse.

When topical treatment is used: If the acne is unusually widespread or bothering a parent, a dermatologist may recommend gentle topical treatments such as azelaic acid. Standard adult acne products like benzoyl peroxide are generally avoided in babies under 3 months because their skin absorbs ingredients more readily.

When to See a Dermatologist

  • The acne has not cleared by 4 to 5 months of age
  • Breakouts start after 3 months of age (rather than in the newborn period)
  • The acne is getting worse rather than better
  • Nodules or cysts appear (deeper, more inflamed bumps)
  • You are unsure if what you are seeing is acne or another skin condition
  • Your baby also shows signs of unusual growth or early hormone activity

Frequently Asked Questions

Is neonatal acne caused by poor hygiene or how I am feeding my baby?

No. Neonatal acne is caused by natural maternal hormones that crossed the placenta before birth — not by hygiene, feeding method, or infant care. There is nothing you did or could have done differently to prevent it. Gentle washing is all you need to do.

Will my baby's acne leave permanent scars?

No. Neonatal acne does not cause scarring. The lesions are superficial and lack the deep inflammation that causes permanent skin changes. Even in babies who develop some pustules, healing is complete without marks. You do not need to rush to treat the acne to protect your baby's skin.

Should I use acne treatments on my baby?

No, not for normal neonatal acne. Most newborn breakouts clear on their own with gentle cleansing and time. Do not apply adult acne products (like benzoyl peroxide, retinols, or salicylic acid cleansers) to a newborn's skin. If you are concerned about your baby's skin, check with a pediatrician or dermatologist before using any product.

When will my baby's acne go away?

Most neonatal acne improves significantly by 3 months and is fully gone by 4 to 6 months of age. Breakouts gradually fade in number and intensity week by week. If acne is still present or worsening after 4 months, contact your pediatrician or a dermatologist — persistent acne beyond that point is called infantile acne and needs further evaluation.

  1. Paller AS, Jaworski JC. Neonatal and infantile acne. Semin Dermatol. 1995;14(2):142-147.
  2. Lookingbill DP, Demers LM, Egan N. Clinical and biochemical studies of acne in the prepubertal and pubertal child. J Am Acad Dermatol. 1991;24(5):734-738.
  3. Herane MI, Ando I. Acne in infancy and acneiform eruptions. Dermatol Clin. 2003;21(3):407-432.
  4. Lucky AW, Biro FM, Huster GA. Acne vulgaris in early adolescent boys. J Pediatr. 1992;121(6):889-895.
  5. Katsambas AD, Dessinioti C. Acne in neonates and infants. In: Acne and Rosacea. Berlin: Springer; 2014.
  6. Shwayder TA, Herrmann JL. Neonatal skin barrier function and dysfunction. Dermatol Clin. 2006;24(4):655-672.
  7. Thiboutot DM, Strauss JS. Diseases of the sebaceous glands. In: Dermatology in General Medicine. 8th ed. New York: McGraw-Hill; 2012.
  8. Webster GF. Pathophysiology of acne. Am J Clin Dermatol. 2020;21(1):13-23.
  9. Zaenglein AL, Pathy AL, Schlosser BJ. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945-973.

Trusted Resources

Always consult a board-certified dermatologist or your healthcare provider for diagnosis and treatment of your specific condition. This article is for educational purposes only.