There are two types of facial skin eruptions in newborns that are very similar in appearance that are often referred to as neonatal acne.
First of which is neonatal cephalic pustulosis, which is a common skin condition that appears in 20% of infants. This results in acne-like lesions on the face, these appear as pink bumps, pus-filled bumps, or a mix of the two. Usually, this affects newborns up to 6 weeks of age. The cause is likely due to skin being colonized by Malassezia and the subsequent inflammatory reaction. In general, there is no treatment needed, and the condition resolves on its own. It is recommended to clean with gentle soap and water. For severe cases, an antifungal cream may be used.
Another type of neonatal acne is called infantile acne, which is less common than neonatal cephalic pustulosis. It typically appears later between 6 weeks and 1 year of age. There are acne lesions on the face as well as whiteheads and blackheads. Infantile acne is due to androgen excess from maternal hormones, resulting in stimulation of the sebaceous (oil) glands. Usually, infantile acne clears up spontaneously. If severe, treatment may be required to prevent scarring. This includes benzoyl peroxide or topical antibiotics, which are also products used for adolescent acne.