Neonatal Cephalic Pustulosis (NCP)

Neonatal cephalic pustulosis is a rare skin condition that affects newborn infants. It is characterized by the development of pustules (small, raised, fluid-filled blisters) on the scalp, forehead, and eyebrows. The pustules are usually yellow or white and may be surrounded by red, scaly skin. The cause of neonatal cephalic pustulosis is unknown, but it is thought to be related to a combination of genetic and environmental factors. In most cases, neonatal cephalic pustulosis resolves on its own within a few weeks to a few months, without causing any long-term damage to the skin. Treatment options may include topical creams and ointments to reduce itching and inflammation, and antibiotics to prevent secondary infections. In severe cases, the pustules may be drained or removed.

Neonatal cephalic pustulosis (NCP) is a skin condition that affects newborn infants. It is characterized by the development of small, yellow-white pustules on the scalp, forehead, and face. The pustules are non-inflammatory and non-infectious, and do not cause any discomfort or harm to the baby.

NCP usually occurs in the first week of life and resolves on its own within 2-4 weeks without treatment. It is believed to be caused by a reaction to maternal hormones that were transferred to the baby during pregnancy, and may also be related to skin irritation caused by tight headwear or exposure to oils or lotions


Neonatal acne is a common skin condition that affects newborns and infants. The main causes of neonatal acne are:

  1. Hormonal changes: Hormonal fluctuations in the newborn’s body can lead to the development of neonatal acne. This is because hormonal imbalances trigger an increase in sebum production, clogging the pores and leading to pimple formation.
  2. Maternal hormones: During pregnancy, the mother’s hormones are passed on to the baby, leading to the formation of neonatal acne. The maternal hormones can cause an increase in sebum production, leading to pimple formation.
  3. Bacteria: Propionibacterium acnes, a type of bacteria commonly found on the skin, can cause neonatal acne. The bacteria feed on the sebum produced by the skin, causing inflammation and pimple formation.
  4. Newborn skin irritation: The baby’s delicate skin may become irritated by certain substances such as baby oil, baby wipes, or harsh soaps, leading to neonatal acne.
  5. Genetics: Some infants may have a genetic predisposition to develop neonatal acne, meaning that the condition runs in families.


The main symptoms of neonatal acne are:

Neonatal acne is a common skin condition that affects newborns and infants up to 3 months of age. It is characterized by the appearance of pimple-like eruptions on the face, neck, chest, and upper back. The following are the main symptoms of neonatal acne:

  1. Pimple-like eruptions: The eruptions are usually small and red, but can also be larger and more pronounced. They may look like tiny whiteheads or blackheads.
  2. Inflammation: The skin surrounding the pimples may be red and inflamed, giving the appearance of a rash.
  3. Scaling and peeling: The skin may peel or flake, especially in areas with a higher concentration of pimples.
  4. Bumpy skin: The skin may feel rough and bumpy to the touch.
  5. Irritation: The skin may be itchy, causing discomfort and distress to the infant.
  6. Fussiness: Infants with neonatal acne may be fussy and irritable, as the skin irritation can cause discomfort and pain.
  7. Small red or white bumps on the face, especially on the forehead, cheeks and chin. -Pustules or pimples. -Mild scaling or flaking of the skin.

It is important to note that neonatal acne is not contagious and is not caused by poor hygiene. It usually resolves on its own within a few months without any treatment. However, if the symptoms persist or worsen, a doctor should be consulted.

Small red or white bumps on the face, especially on the forehead, cheeks and chin. -Pustules or pimples. -Mild scaling or flaking of the skin.


Neonatal acne is a common skin condition that affects newborn infants, usually appearing within the first few weeks of life. The main diagnosis for neonatal acne is often made by physical examination of the skin.

There is no specific test for neonatal acne, but the following tests may be conducted to rule out other skin conditions:

  1. Skin culture: A swab of the affected area may be taken and sent to a laboratory for analysis to rule out any bacterial infections.
  2. Wood’s Lamp Test: A Wood’s lamp is a special type of ultraviolet light that is used to help diagnose skin conditions. This test can help to differentiate between neonatal acne and other skin conditions that may appear similar.
  3. Blood tests: A blood test may be conducted to check for underlying medical conditions, such as a hormonal imbalance, that may be contributing to the neonatal acne.

In most cases, a physical examination and observation over time is sufficient to make a diagnosis of neonatal acne. It is important to consult a pediatrician or dermatologist for proper diagnosis and treatment.


In general, most patients diagnosed with infantile acne have a moderate course at best requiring no treatment, resolving within 6 to 12 months of initial onset. However, some cases can be severe enough to warrant the initiation of medication. Due to a lack of high-quality clinical trials, especially from randomized controlled trials, there are no USFDA-approved medications for the treatment of acne vulgaris in patients under the age of nine.  As such, recommendations regarding therapeutic intervention for infantile acne derive from empiric observations of both adolescent and adult populations. Simply stated, the treatment of infantile acne is essentially the same therapeutic approach for acne vulgaris of any age.

For mild infantile acne, start with a topical agent such as a topical retinoid or benzoyl peroxide. They can be used as monotherapy or in combination. For mild inflammatory acne, the addition of a topical antibiotic (e.g., erythromycin or clindamycin) to the regimen above would be appropriate. Remember to avoid using a topical antibiotic as a monotherapy for acne of any age given the growing emergence of resistant bacterial strains of Propionibacterium acnes. In particular, simultaneous use of benzoyl peroxide, given its inherent nonspecific antimicrobial activity, has shown to be effective in preventing this trend.

The following steps are recommended for treatment:

  1. Gentle cleansing: Wash the affected area with a mild soap or baby wash and warm water. Avoid using harsh chemicals or scrubs as they can irritate the skin.
  2. Leave the acne alone: Don’t squeeze or pick at the pimples as it can cause infection and scarring.
  3. Moisturize: Keep the skin moisturized by using a gentle lotion or cream.
  4. Avoid irritants: Keep the baby away from harsh chemicals and products that can irritate the skin, such as fragrances and dyes.
  5. Consult with a pediatrician: If the acne persists or gets worse, it’s best to consult with a pediatrician for proper evaluation and treatment. In some cases, topical or oral antibiotics may be prescribed.

It’s important to note that neonatal acne is a benign and temporary condition that usually resolves on its own within a few weeks or months