Baby Eczema vs. Acne: Symptoms, Causes, Treatment

When a baby gets a rash, it can be very frightening. However, rashes are common in babies; two of the most common among them are eczema and acne. Baby eczema and acne both produce red skin with raised areas. But eczema causes dry, itchy patches, whereas acne causes non-itchy bumps.

This article will discuss the similarities and differences between baby eczema and acne. It will also cover treatments and preventative measures to help restore the baby’s soft skin.

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Symptoms

Baby acne and eczema are both common rashes in newborns. Baby acne, also called neonatal acne, occurs in 20% of newborns. Eczema occurs in about 10% of babies. There are not many symptoms that overlap between the two rashes. The primary similarity between the two conditions is a red rash.

Here is a list to help distinguish the differences:

Baby Eczema

  • Dry, itchy skin

  • Skin scales

  • Bumps that leak fluid and crust over

  • Rash comes and goes

  • Rash appears on face, arms, or legs

  • Develops between 6 months and 5 years of age

Baby Acne

  • Pimples on or around the face

  • No skin scales

  • Pimples do not leak fluid

  • Typically resolves within four months

  • Acne stays on the face

  • Develops around 3 or 4 weeks of age

Causes

Though baby acne and eczema have similar features, they have very different causes. Below are the causes of baby acne and eczema.

Baby Acne

Baby acne is a harmless rash that happens for reasons similar to that of adolescent acne: fluctuating hormones. Experts believe the mother’s androgen hormones are one of the causes of baby acne. When the baby is still in its mother, it receives androgen hormones. These hormones stimulate oil production on the skin. After the baby is born, its adrenal glands start producing androgen hormones producing more oil which can result in acne.

Baby Eczema

Issues with the skin’s barrier cause baby eczema. Some people with eczema do not have enough of the protein filaggrin on the outer layer of their skin. Filaggrin helps form a barrier between the skin and the environment. Other causes include a baby’s genes and environment. Eczema tends to run in families and those with allergies.

Diagnosis

There are no specific diagnostic tools to diagnose baby acne and eczema. Baby acne and eczema are diagnosed in similar ways by visual observation.

A healthcare provider will look at the baby’s rash. They may ask the guardians questions about the baby’s health history and the health history of family members.

Baby acne tends to show up before the baby is 6 weeks old. Eczema tends to develop around 6 months old or after.

Another key factor is that eczema is itchy and has scaly patches. Baby acne does not itch and presents with pimples and redness.

Treatment

Baby acne and eczema have very different treatments. Therefore, it’s important to get a proper diagnosis to avoid mistreating the rash.

Baby Acne

Baby acne is typically self-limiting and does not cause harm to the baby. It can be upsetting for some guardians, who may ask their healthcare providers for treatment. The American Family Physician journal encourages healthcare providers to remind guardians that baby acne usually goes away in a few months without treatment.

The source continues to say that if the acne is significant and does not resolve, 2.5% benzoyl peroxide lotion may help.

Baby Eczema

There is no cure for eczema, but many treatments are available to help manage the symptoms. Treatments may include:

  • Moisturizers: Skin should be moisturized two to three times per day with a cream or oil-based moisturizer. The best time to moisturize is when the baby has been dried after a bath.
  • Steroid cream: A healthcare provider may recommend a steroid cream for moderate to severe eczema. Steroid creams can reduce inflammation and itching. It’s important to follow the directions and only use the prescribed amount.
  • Oral medication: Certain oral medications may reduce itching or infection.

Other treatments may include a bleach bath, phototherapy, or wet wraps. However, it is always best to talk to a healthcare provider to determine the best treatment.

Prevention

There is nothing that can prevent baby acne. It just needs to run its course. If it does not get better on its own, then a healthcare provider may suggest treatment.

Though there is no way to completely prevent eczema, there are ways to minimize flare-ups:

  • Keep baths short and use warm (not hot) water
  • Keep the baby’s fingernails short so they do not scratch themselves
  • Have the baby wear clothes made of breathable cotton instead of wool or polyester
  • Avoid any known allergens
  • Moisturize the baby’s skin frequently

Summary

Acne and eczema are two common skin conditions found in babies. They both cause redness and rashes. However, baby acne tends to stay on the baby’s face and also causes pimples. Eczema is different and causes itchy, scaly patches that can show up almost anywhere on the skin. Baby acne usually goes away on its own. But eczema can stick around for a while and require treatment.

A Word From Verywell

Baby acne can feel like a cause for concern. So many conditions cause rashes, making it hard to know the difference between them. You should contact your healthcare provider whenever your baby has a rash. They will be able to diagnose the rash based on its appearance and ensure that you have the proper treatment plan.


By Patty Weasler, RN, BSN

Patty is a registered nurse with over a decade of experience in pediatric critical care. Her passion is writing health and wellness content that anyone can understand and use.