What’s the Difference Between Baby Acne, Milk Spots, and Milk Rash?

When raised bumps or spots appear on your new baby’s previously perfect skin, it can cause concern – not least as allergies such as CMPA become more common. But does your infant have baby acne, milk spots, or milk rash – and what’s the difference between them? Are your baby’s spots harmless, or a more serious allergy reaction rash? 

What’s the Difference Between Baby Acne, Milk Spots, or Milk Rash?

One is thought to be hormonal, one a response to the environment outside of the womb, and one an allergy reaction. But which is which, and how serious are they? This post will help you identify and distinguish between these three infant skin complaints.

Baby Acne

What Is Baby Acne?

Affecting around 20% of babies, baby acne (also known as neonatal acne) is common. Occasionally baby acne can be present at birth, however it more commonly develops in the first few weeks of life.

Baby Acne Symptoms: What Does Baby Acne Look Like?

Baby acne presents as small spots or whiteheads, usually on your baby’s cheeks, though it can appear anywhere on the face. Unlike infantile acne, baby acne does not usually appear as blackheads.

The affected area may be a little red and irritated, and fussing or crying may make the acne more pronounced. Baby acne can sometimes also develop on the upper back and neck.

What Causes Baby Acne?

Health professionals believe baby acne may be caused by the maternal hormones surging through the body around the time of birth.

How Serious is Baby Acne?

Unlike infantile acne which is less common and more complicated, baby acne is harmless and usually resolves itself within a few weeks or months. Infantile acne can remain until toddlerhood and in untreated cases may rarely result in scarring.

Do I Need to See a Doctor About Baby Acne?

You don’t need to see a GP unless you have specific concerns or the spots worsen or remain after the few months of life.

Milk Spots, Also Known as Milia

What Are Milia?

Milia are tiny white bumps that appear on the face, typically on the nose, chin, and cheeks, although they can also develop on the chest, arms, and legs. Sometimes they can appear in and around the baby’s mouth and oral milia are known as Epstein pearls.

Milia often mistakenly referred to as baby acne or milk rash, which are not the same, however it’s worth noting that they may occur together.

Milia Symptoms: What Do Milia Look Like?

Milia have a distinctive appearance and are often called milk spots because of their appearance – they resemble a spray of milk on the face – however, they’re not linked to either breastfeeding or formula.

The white bumps are deep under the skin and do not have the typical redness or swelling associated with whiteheads.

What Causes Milia?

Milia and oral milia are caused by flakes of dead skin becoming trapped in pockets under the skin.

They are unrelated to how the baby is fed, or the mother’s diet if breastfeeding.

How Serious is Milia?

Milia and Epstein pearls are common and completely harmless. They usually disappear within three months of birth.

Milia can affect older children and adults, though there’s usually a cause, such as injury or inflammation.

Do I Need to See a Doctor About Milia?

There’s no need to see a GP unless you have specific concerns or the bumps worsen or remain after the few months of life.

Milk Rash

What Is Milk Rash?

Milk rash occurs as a result of exposure to an allergen. One of the most common allergies in babies is CMPA, or cow’s milk protein allergy. CMPA affects around 2-3% of babies, but it’s much rarer for baby’s to react through breastmilk than direct exposure via formula (around 0.5%).

Milk Rash Symptoms: What Does Milk Rash Look Like?

Milk rash or CMPA rash looks like severe acne. The rash is often angry and extensive, creeping beyond the hairline and onto the ears. Eliminating the allergen from the infant’s diet will allow the rash to heal and disappear.

What Causes Milk Rash?

CMPA is caused by an abnormal response to cow’s milk protein by the immune system.

How Serious is Milk Rash?

The seriousness of the rash relates to the allergy, as opposed to the superficial aspect of the rash itself. Allergies vary in severity, but should not be ignored. More information on identifying and managing CMPA.

Do I Need to See a Doctor About Milk Rash/CMPA?

It’s recommended to seek help from a dietitian who specialises in allergies once diagnosis is confirmed. Referral is via your GP.

Looking After Baby’s Skin: Treatment for Baby Acne, Milia, or Milk Rash

Although blemishes on your infant’s face may be unsightly and undesirable, in most cases they are completely harmless and require no treatment. This is not true of allergies which require attention and support from health professionals.

To best care for your baby’s delicate skin:

• Keep the face clean – gently wipe away milk, spit up, and vomit promptly;
• Be gentle – avoid using harsh chemicals or scented products which may irritate the skin, and pat, don’t rub dry;
• Leave spots alone – don’t squeeze or scrub as this may aggravate the condition.

If symptoms worsen or appear to distress your baby, or if you have any other concerns, always see your GP.