baby boy on bed with rash on cheeks

How To Recognize (& Treat) Baby Eczema Vs. Acne

Knowing which is which is key in treating baby’s itchy skin.

Newborns are known for their delicious scent and their delicately smooth skin. But sometimes your baby’s skin can take a turn and look more like a teenager’s than someone who’s only a few weeks or months old. If you see bumps on their skin, you’ll need to know the difference between baby acne vs. eczema, because there’s a big difference in how to treat it.

Before you can even give your bumpy baby some relief, you’ll need to know what kind of skin situation your baby is dealing with. Fortunately, assessing what sort of issue your baby is having can be done simply by looking at them, Dr. Mona Amin, MD, a board-certified general pediatrician tells Romper. “Babies have sensitive skin and some are way more sensitive than others,” she says. “The big difference is acne tends to be more bumps or papules, similar to acne we see in puberty whereas eczema is more rough, red patches.” The hard part is when your baby experiences both acne and eczema together (yes, it can happen).

Here’s How Baby Acne Happens

Acne doesn’t take too long to make an appearance on your baby’s skin. In fact, it can start sometime soon after their birth, Dr. Alison Mitzner, MD, a pediatrician and author of Calm and Confident Parenting tells Romper. “In the first month of life, some newborns may develop acne on their faces,” says Dr. Mitzner. “This is due to the exposure of maternal hormones in utero.” As it turns out, infantile acne is more common in boys than girls, according to a PubMed study, and is usually diagnosed by the presence of comedones (which are the bumps you see under Baby’s skin). While acne can occur at any age, it can happen to your baby during their first few weeks of life.

But what does it actually look like? Dr. Arunima Agarwal,, M.D., a board-certified general pediatrician, explains: “Infantile acne consists of typical acneiform lesions, including comedones, inflammatory papules, pustules, and, sometimes, nodules on the face,” she says.

Here’s How Baby Eczema Occurs

Eczema, on the other hand, isn’t just a few pimples on the skin’s surface. It’s actually a lot more intense than that. “Eczema, medically known as Atopic dermatitis, is a chronic, pruritic, inflammatory skin disease that occurs most frequently in children but also affects many adults,” says Dr. Agarwal. “The fact that it is a chronic condition differentiates it from infant acne, which is self-limited.” And that’s one of the major ways you can tell the difference between baby eczema vs. acne: eczema is chronic while baby acne will eventually go away.

How Do You Treat Baby Acne?

If your baby has acne, it’s (thankfully) not a chronic condition. “Infantine acne usually clears spontaneously by late in the first year of life but may persist until three years of age,” says Dr. Agarwal. “Topical benzoyl peroxide or topical antibiotic can be used for severe cases.” While baby acne resolves on its own, you definitely don’t want to do anything to exacerbate the issue. So avoid irritants like harsh detergents and soaps so that your baby doesn’t feel uncomfortable.

How Do You Treat Baby Eczema?

In order to treat baby eczema, it’s important to understand what causes it in the first place. For the most part, atopic eczema happens during a child’s first year of life, a PubMed study reported, and researchers found that kids with eczema often have an allergy to house dust mites. So how does that lead to the red, rashy skin? Dr. Amin explains: “The primary function of our skin barrier is to restrict water loss and to prevent entry of external pathogens,” she says. “One of the ongoing research behind eczema is looking at a protein called filaggrin that can have loss-of-function in many moderate to severe cases of eczema.” Due to the lack of filaggrin which leads to more water loss through the skin, this leads to extremely dry (and itchy) skin. And because it’s itchy, your child is bound to scratch their skin, which makes it even more inflamed, causing your kiddo to get caught in a never-ending itch-scratch cycle.

So how do you treat it? Moisturizing is mega important, says Dr. Amin. “Moisturizing should be a part of your child’s treatment plan whenever the skin is dry,” she says. “Use fragrance-free moisturizers, because moisturizing is key in eczema.” Since your baby’s skin is losing moisture fast, so you really want to reapply a greasier moisturizer as often as needed, but especially so when the skin is still damp, like right after Baby’s bath. And unlike baby acne, baby eczema can be hereditary. “Often eczema runs in families and occurs often with those with allergies,” Dr. Mitzner explains.

Here’s When To Take Your Baby To The Doctor

If your baby is really uncomfortable, (i.e. it’s affecting their daily life or even sleep schedule), you might want to consult with their pediatrician, who might recommend a visit to an allergist or dermatologist to help ease the itch and identify the real issue behind Baby’s skin irritation. It’s also important to look for lesions: “Keep an eye out for a potential skin infection — look for red streaks, pus, yellow scabs or an open wound/lesion,” advises Dr. Agarwal. Your pediatrician might recommend anti-itch medications or even an antihistamine to help soothe the suffering.

Seeing your baby’s sweet skin covered in bumps might be a bummer, but know that it’s not permanent. Speak with your pediatrician to confirm if it’s baby acne or eczema, and then seek the proper treatment. That way, their skin will be beautiful — and not bumpy.

Studies cited:

Poole, C., McNair, V. “Infantile Acne” 2021.

Barnetson, R., Rogers, M. “Childhood Atopic Eczema” 2002.


Dr. Mona Amin, MD, a board-certified general pediatrician

Dr. Alison Mitzner, MD, a pediatrician and author of Calm and Confident Parenting

Dr. Arunima Agarwal,, M.D., a board-certified general pediatrician