Baby acne and milia: two harmless skin things

Two of the most common newborn skin findings — baby acne and milia — worry parents every day despite being completely harmless. Neither requires treatment. Both resolve on their own. Understanding what they are makes the waiting much easier.

Baby acne

Baby acne (neonatal acne) appears as small red or white pimples, typically on the cheeks, nose, and forehead. It looks disconcertingly like teenage acne but has a different mechanism entirely.¹

When it appears: Usually between 2 and 6 weeks of age, though some babies have it from birth.

Why it happens: Maternal hormones passed through the placenta or breastmilk stimulate the baby's oil glands during the weeks after birth. As those hormones clear the baby's system, the acne resolves. It is not caused by diet, dirty skin, or anything the parent has done.¹

When it clears: Most baby acne resolves by 3–4 months of age without any treatment.

What to do: Nothing. Wash your baby's face once daily with plain warm water and a soft cloth — no soap, no scrubbing. Do not apply acne creams, toners, adult cleansers, or any over-the-counter acne treatments. These products are formulated for adult skin and can cause chemical burns or worsen irritation in newborns.¹

What not to do: Do not squeeze or pick the spots. Do not apply lotions or oils to the affected area. Do not use steroid creams without a GP's advice.

Milia

Milia are tiny white or yellowish bumps — usually 1–2 mm — most commonly seen on the nose, cheeks, chin, and forehead. They look like small whiteheads but are not related to oil glands or hormones.²

What they are: Milia form when small flakes of keratin (a skin protein) become trapped under the surface of the skin. In newborns, this happens because the skin's drainage channels are not yet fully mature.²

When they appear: Milia are often present at birth or within the first days of life. Around 40–50% of newborns have them.²

When they clear: Within a few weeks to a couple of months, as the skin matures and the trapped keratin naturally works its way out.

What to do: Nothing. Milia require no treatment. Do not squeeze, pick, or attempt to drain them — this can introduce infection and cause scarring.

Distinguishing baby acne from milia

Neonatal cephalic pustulosis

A third condition sometimes confused with baby acne is neonatal cephalic pustulosis — inflammatory pustules on the face and scalp caused by a reaction to Malassezia yeast (the same yeast involved in cradle cap). It looks very similar to baby acne and is managed the same way: gently, without intervention. It resolves on its own.³

When to see your doctor

See your GP if:

• The spots are spreading rapidly to the body, neck, or limbs
• The rash looks different from typical baby acne — deep, cystic, or with surrounding redness and warmth — which could suggest a yeast infection or bacterial folliculitis
• Baby acne has not resolved by 4 months, or milia have not cleared by 3 months
• Your baby develops spots alongside fever, feeding difficulties, or general unwell behaviour
• You're uncertain whether what you're seeing is acne, milia, or something else

If you're ever unsure, it's worth showing your GP or health visitor rather than waiting.

← Back to the complete guide: Baby health basics

Also in this cluster: Cradle cap · Common newborn rashes

Sources

1. American Academy of Pediatrics (AAP) / HealthyChildren.org. "Baby Acne." HealthyChildren.org, 2022. https://www.healthychildren.org/English/ages-stages/baby/bathing-skin-care/Pages/Baby-Acne.aspx
2. American Academy of Pediatrics (AAP) / HealthyChildren.org. "Milia." HealthyChildren.org, 2022. https://www.healthychildren.org/English/ages-stages/baby/bathing-skin-care/Pages/Milia.aspx
3. NHS. "Looking After Your Baby's Skin." NHS, 2023. https://www.nhs.uk/conditions/baby/caring-for-a-newborn/looking-after-your-babys-skin/