Erythema toxicum neonatorum (ETN) is a common skin rash that appears on about half of newborn infants. The rash generally appears on the face or midsection of the body, though it may appear on the arms or thighs. The rash appears as yellow-to-white bumps surrounded by red skin and looks similar to a cluster of fleabites.
ETN usually occurs within three to 14 days of birth, though it may appear within a few hours after birth. Though ETN might worry new parents, there is no cause for alarm. ETN goes away without treatment and is not at all dangerous.
The cause of ETN is currently unknown. Newborns often experience many harmless changes in appearance that are temporary.
ETN causes a red rash in which tiny white or yellowish papules (bumps) are visible. The papules are noncancerous and benign. There may be many papules, or just a few. They are firm to the touch, and may secrete a fluid that resembles (but is not) pus.
ETN is usually present on the midsection of the body or the face, though it can appear on the upper arms and legs. ETN may move around on the body, appearing on the face one day and the thighs the next day. The condition does not cause your baby to feel any discomfort.
According to the National Center for Biotechnology Information, testing is not usually necessary to determine whether your baby has ETN (NCBI, 2011). Your healthcare provider can usually make the diagnosis just by examining your baby during a routine checkup.
ETN does not require treatment. No changes in skin care are necessary.
The condition typically goes away in two weeks to four months without causing any complications.
ETN is similar to several other harmless newborn skin conditions.
Baby acne (Acne neonatorum) occurs in about one-fifth of newborns. Like adult acne, baby acne generally appears on the cheeks and forehead. The small red pimples are thought to be caused by maternal hormones. They generally go away without treatment within a couple of months. Do not attempt to pop or squeeze the pimples. Doing so may cause an infection.
Milia are pimple-like, hard white cysts that form from the baby’s oil glands. They are common in most infants and typically appear on a newborn baby’s nose, chin, and/or forehead. They generally go away without treatment within a few weeks and do not leave scars. If skin irritation from a blanket or clothing occurs along with milia, the condition may resemble ETN.
Epstein pearls is the name given to milia that appear in the gums or in the mouth. According to the NCBI, they occur in about 80 percent of infants and disappear in one to two weeks (NCBI, 2011). They may resemble new teeth when they appear on the gums.
Adults can also develop milia. A doctor may remove milia from adults for cosmetic reasons, but there is no reason to do this with infants.