Common Newborn Rashes — what's normal and what isn't
An overview of newborn rashes — erythema toxicum, milia, baby acne, slate-grey patches, salmon patches, heat rash, peeling skin — and the red flags that need urgent review.
- Last reviewed
- Sources cited
- 6 sources
- Author
- Dr Jubal John, FRACP
- Category
- medical guides
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We’re double-checking this content before publishing it — it’ll be available here shortly.
In the meantime, browse the published guides or contact the rooms.
Take-home
Most rashes that appear in the first weeks of life are harmless and self-resolving. Newborn skin is still figuring itself out, and a remarkable number of bumps, blotches and patches are completely normal stages of that process. No treatment is needed for most of them. The short list of rashes that do need urgent review, non-blanching spots, vesicles, a rash with fever or an unwell baby, is below.
When to seek help: the short version
Green — usually fine
Green: completely normal, no action needed
- Erythema toxicum (yellow-white bumps on red bases, day 2-5)
- Milia (tiny white dots on the nose)
- Baby acne (red papules and pustules on the face, weeks 2-6)
- Slate-grey patches / congenital dermal melanocytosis (blue-grey patches on the lower back or buttocks)
- Salmon patches / “stork bites” / “angel kisses” (flat pink marks on the nape, eyelids or forehead)
- Peeling skin in the first week or two
- Mild heat rash on a warm day
Amber — be alert
Amber: see your GP, paediatrician, or MCH nurse if not improving
- A rash that is steadily spreading
- A rash with weeping, crusting, or skin that’s broken
- Eczema-type rashes (dry, red, itchy patches): see eczema management
- Persistent nappy rash, see nappy rash
- Cradle cap, see cradle cap
- A rash that is making your baby visibly uncomfortable or scratch a lot
- Any rash where you’re not sure what it is
Red — act now
Red: call 000 or go to your nearest emergency department
- A non-blanching rash: purple or red spots that don’t fade when you press a glass against them. This can be a sign of meningitis or sepsis.
- Vesicles (small fluid-filled blisters) on the face, scalp, or in the mouth, particularly clustered, within the first 4-6 weeks of life. This can be neonatal herpes simplex virus (HSV), which is rare but a medical emergency.
- A rash with fever in a baby under 3 months old (any temperature ≥38°C)
- A rash with a baby who is unwell, floppy, feeding poorly, or hard to wake
- Generalised redness with peeling, blistering, or sloughing of skin: rare but serious (staphylococcal scalded skin syndrome and others)
- Rapid spread of redness around a single point (could be cellulitis)
The transient rashes you’ll probably see
These are the rashes most parents notice on a newborn, listed in roughly the order they appear. All of them resolve on their own. Skip to “What to bring to a review” below if your baby’s rash doesn’t match any of these.
Erythema toxicum neonatorum (ETN)
Yellow-white bumps on red bases, scattered anywhere except palms and soles, sometimes described as “flea bites”. Days 2-5, in up to half of all term babies. Cause is unclear (probably an immune skin response to life outside the womb). Nothing to do: spots come and go in different places and are gone within 1-2 weeks.
Milia
Tiny pinhead-sized white dots on nose, cheeks, chin or forehead. Present at birth or in the first few days. Trapped skin cells in pores that haven’t opened yet. Don’t squeeze: they open on their own within about 4 weeks.
Neonatal acne (“milk spots” / baby acne)
Red papules and small pustules on cheeks, forehead and chin, like teenage acne on a tiny face. Weeks 2-6, peaking 3-4 weeks. Sebaceous glands responding to maternal hormones. Wash once a day with water only: no soaps, no creams. Resolves by 3-4 months.
Transient neonatal pustular melanosis (TNPM)
Small pustules that quickly burst to leave brown spots with a fine ring of peeling skin around them, more common in babies with darker skin. Present at birth or first day or two. Nothing to do: brown spots fade over weeks to months and leave no scar.
Slate-grey patches (congenital dermal melanocytosis, previously called Mongolian spots)
Flat blue-grey or slate-coloured patches, most often on lower back or buttocks but sometimes shoulders or arms, can look bruise-like. Present at birth, especially common in babies with darker skin (Asian, African, Indigenous, Latin American, Mediterranean heritage). They fade over the first few years, sometimes persisting into childhood. They are not bruises, but worth asking your GP, paediatrician or MCH nurse to document them so they aren’t mistaken for one later.
Salmon patches (“stork bite”, “angel kiss”)
Flat pink-red patches on nape, eyelids, forehead or upper lip, brighter when baby cries or is hot. A vascular birthmark, not a problem. Eyelid and forehead ones usually fade by 1-2 years; nape ones often persist but are hidden by hair.
Miliaria (heat rash, “prickly heat”)
Tiny red bumps or clear pinhead blisters in skin folds (neck, groin, armpits) or on the chest and face, wherever the baby has been sweaty. Cool the baby down: lighter clothing, fewer layers, cooler room. The rash settles within hours.
Peeling skin
Sheets or flakes of dry skin coming off wrists, ankles, hands and feet, first week or two, especially in babies born after their due date or after a long labour. The vernix that coated baby in the womb comes off; underlying skin sheds its outer layer. Don’t peel sheets off, no creams needed: a bath in plain warm water and natural shedding sorts it. If the skin underneath looks red, raw, or inflamed, see your GP or MCH nurse.
Skincare in the first weeks: less is more
The current advice
The Royal Children’s Hospital, the Australasian College of Dermatologists, and the Australian Department of Health all converge on a simple principle for the first weeks: plain water, cotton, and patience.
- Bath in plain warm water: once daily is plenty; every second or third day is also fine.
- No soap on the body for the first weeks. If you want a wash product, use a small amount of a mild, fragrance-free wash designed for babies.
- No bubble baths, no perfumed lotions, no antiseptic washes, no antibacterial wipes.
- Cotton clothing beats synthetic in the first weeks. Wash new clothes once before wearing.
- Pat dry: skin folds (neck, groin, behind ears) should be dry to prevent thrush and miliaria.
- Moisturiser is only needed if your baby has dry or eczema-prone skin. Plain water and air-drying is usually enough.
For more detail, see Royal Children’s Hospital — Skincare for babies.
Specific rashes covered elsewhere on this site
Some of the rashes that show up beyond the first few weeks have their own guides:
- Nappy rash: contact dermatitis from urine and stool, plus how to spot thrush
- Cradle cap: yellow scaly patches on the scalp
- Eczema management: dry, red, itchy patches; daily routine, topical steroid use, allergy connection
What to bring to a review
If you’re unsure about a rash and want it looked at, photographs help. Bring:
- Clear photos in good light, taken close up (most phones do this well)
- Notes on timing: when the rash appeared, whether it’s spreading, what changed
- A list of any creams, soaps or detergents you’ve started or changed recently
- The baby’s general state: feeding, sleeping, temperature, mood
Most of the rashes above need only reassurance plus time. The judgment call between “wait” and “treat” is what your GP, paediatrician or MCH nurse is there to help with.
Concerned about your baby's skin?
If a rash is spreading, your baby has a fever, or you're unsure, call (03) 9007 2099 (Mon-Fri 9-5), or your GP or MCH nurse (13 22 29) any time.