One of the most common newborn questions we get is whether the rash that is covering a new baby is something to be concerned about. Luckily, the newborn rash, called erythema toxicum, or erythema toxicum neonatorum, is very common and very normal.
Erythema toxicum occurs in almost half of all newborns, and can appear as red splotches and/or fluid-filled pustules. The rash often begins in the face and spreads to the trunk, arms and legs. It usually does not present on the soles of the feet or palms of the hands. The first appearance is usually in the first couple of days after birth, and usually resolves within one to two weeks, but the rash can occur any time in the first six weeks. There can be just a few spots, or the body can appear covered with angry weals – quite an alarming sight for a new parents. But, again, rest assured – this rash is benign.
No one really knows what causes erythema toxicum, but theories include immature hair follicles, exposure to meconium, or hormonal changes. The rash is usually diagnosed just by visual confirmation, but if there is doubt, a smear test of the lesions can be performed. There isn’t anything special that needs to be done to treat erythema toxicum, but we do recommend keeping the newborn’s skin dry and open to air if it is warm in the room.
Though erythema toxicum is nothing to be concerned about, always seek further medical evaluation if your baby has a fever, high-pitched crying, or otherwise appears to be ill.