Toxic erythema of the newborn might sound like a worrying condition. In fact, erythema toxicum is a benign and harmless rash that occurs in newborn babies, usually within a few days of birth and it resolves within two weeks of life.
Read on to find out more about erythema toxicum (newborn rash).
Signs and symptoms of newborn rash
Erythema toxicum, sometimes simply referred to as ‘newborn rash’, is a common rash that might appear on a baby’s skin soon after birth.
The rash usually appears first on a baby’s face, then extends to the torso, arms and legs. It rarely occurs on the palms of the hands or the soles of the feet.
Erythema toxicum (newborn rash) can appear as a combination of flat patches, tiny red bumps or pustules, but it might look brown or purple on darker skin.
What causes newborn skin rash?
Although the exact cause of erythema toxicum is not fully understood, it is thought to be associated with a reaction of the baby’s skin to meconium – the first stool of a newborn baby – and the developing immune system.
You can read more about meconium in BellyBelly’s article Meconium – What Is It? 9 Things You Need To Know.
It is known that erythema toxicum is not caused by a skin infection, is not contagious, and will resolve spontaneously without special treatment.
How common is erythema toxicum in newborns?
Erythema toxicum occurs in up to half of all full term infants but is less common in premature babies.
A 2017 study found it to be most common in Caucasian male babies.
It can occur in any gender or race, but is believed to be under-diagnosed or less frequently recognized in infants with darker skin types.
Where does the name erythema toxicum neonatorum come from?
Cases of erythema of the newborn have been recorded since the 15th century. The name used to describe the condition, however, has changed several times over the years.
In 1912, an Austrian pediatrician, Dr. Karl Leiner, named the condition erythema toxicum neonatorum and this is the name it’s currently known by.
In medical terms, ‘erythema’ means ‘red skin’. The term ‘toxicum’ sounds like ‘toxic’ but can be misleading; the condition is harmless to infants. ‘Neonatorum’ refers to the period of time when a baby is less than one month old.
Does your child need to see a doctor about erythema toxicum?
Erythema toxicum does not require medical diagnosis or treatment. You should, however, discuss with your baby’s provider any rashes or conditions that cause you concern.
If you notice a rash on your newborn baby’s body, in conjunction with any other symptoms, such as a fever, excessive drowsiness or poor feeding, you should seek urgent medial attention.
How long does erythema toxicum neonatorum last?
In most cases, the onset of erythema toxicum begins within the first few days of life, with the peak onset being 48 hours after birth. The symptoms have usually disappeared by the time the infant is around 2 weeks old.
In some babies, a rash might be present for longer, but should be completely resolved by 4 months of age.
Are there any long-term effects?
There are no long-term effects of erythema toxicum. The rash is not associated with an infection and does not cause harm or discomfort to a newborn baby.
If your baby is experiencing an ongoing skin condition, you should discuss this with the doctor.
How to treat erythema toxicum
There is no special treatment required for erythema toxicum neonatorum. You can continue to care for your newborn baby’s skin as normal.
Generally speaking, newborn babies have very sensitive skin. After your baby’s birth, you should delay the first bath for at least 24 hours.
You can read more about this in BellyBelly’d article Your Baby’s First Bath | 6 Serious Reasons To Delay.
Baby’s first bath
When you are ready for your baby’s first bath, here are some tips for caring for your baby’s delicate skin:
- Avoid bathing your baby daily; twice or three times a week is enough
- Keep bath times short – between 5 and 10 minutes
- Make sure the water is lukewarm and not too hot
- Avoid soaps or moisturizers that contain harsh chemicals or fragrances
- Make sure your baby is completely dry before dressing.
How to avoid erythema toxicum getting worse
As well as the tips on bathing your baby (above), the best treatment for erythema toxicum is to leave it alone and let it pass with time.
You should not attempt to squeeze or pop any pustules, as this could lead to infection. Using ointments, oils or lotions directly on the rash can also make it worse.
Other skin conditions in newborns and infants
Sometimes, people refer to erythema toxicum neonatorum as baby acne. But baby acne (or acne neonatorum) is a different skin condition. It has similar symptoms but usually lasts longer than erythema toxicum.
You can read more about baby acne in BellyBelly’s article Baby Acne | Symptoms, Causes And Treatment.
You might notice the skin on your baby’s body starts to peel after birth. This is normal.
For more information you can read BellyBelly’s article Newborn Skin Peeling – 7 Simple Tips To Manage Peeling Skin.
Other common rashes you might see on your newborn’s skin are:
- Milia or ‘milk spots’
- Miliaria rubra or ‘heat rash’
- Transient neonatal pustular melanosis
- Drooling or spit-up rash, seen around the mouth and chin
- Stork bites – pink birthmarks on the nose or back of the neck that often fade with time
- Infantile seborrheic dermatitis (cradle cap).
Treatment options for infantile seborrheic dermatitis
Like erythema toxicum, seborrheic dermatitis (cradle cap) is a common newborn skin condition that does not require specific treatment or diagnosis. Even so, lots of parents worry about the appearance of cradle cap and are interested in treatment options for their babies.
For more information, you can read BellyBelly’s article Cradle Cap | 2 Main Causes Of Dermatitis.
