My Baby Was Born with a Raw Spot on Their Scalp (Aplasia Cutis)
Medically reviewed by Dr. Sarah Chen, MD, FAAP · Board-Certified Pediatrician
Content reviewed against published NIH, DermNet, NORD guidelines
Last reviewed:
Baby skin is sensitive and changes frequently. If you are noticing was born with a raw spot on their scalp (aplasia cutis), here is what you need to know.
The short answer
Aplasia cutis congenita (ACC) is a condition where a baby is born with a small area of missing skin, most commonly on the scalp. It occurs in about 1 in 10,000 births. The affected area may look like a raw wound, an ulcer, or may have already healed into a thin, shiny scar by the time of birth. Most cases are small, isolated, and heal well with basic wound care — the area eventually forms a hairless scar. Larger defects or those associated with other findings may need more investigation, but isolated small ACC has an excellent prognosis.
Key takeaways
- Aplasia cutis congenita (ACC) is a condition where a baby is born with a small area of missing skin, most commonly on the scalp. It occurs in about 1 in 10,000 births. The affected area may look like a raw wound, an ulcer, or may have already healed into a thin, shiny scar by the time of birth. Most cases are small, isolated, and heal well with basic wound care — the area eventually forms a hairless scar. Larger defects or those associated with other findings may need more investigation, but isolated small ACC has an excellent prognosis.
- Usually normal when: Your baby has a small aplasia cutis area on the scalp that is healing with basic wound care
- Call your doctor if: The ACC area is bleeding heavily and the bleeding does not stop with gentle pressure — seek emergency care
- Varies by age — see the age-by-age breakdown below
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What Parents Should Know
According to NIH, DermNet, NORD guidelines, aplasia cutis congenita (ACC) is a condition where a baby is born with a small area of missing skin, most commonly on the scalp. It occurs in about 1 in 10,000 births. The affected area may look like a raw wound, an ulcer, or may have already healed into a thin, shiny scar by the time of birth. Most cases are small, isolated, and heal well with basic wound care — the area eventually forms a hairless scar. Larger defects or those associated with other findings may need more investigation, but isolated small ACC has an excellent prognosis. At 0-1 month, at birth, the aplasia cutis area may appear as a raw, red patch, a shallow ulcer, or a thin membrane-covered area on the scalp. Your medical team will assess the size and depth. Small, superficial defects (which are the vast majority) are managed with gentle wound care — keeping the area clean and protected. Larger or deeper defects, particularly those overlying a fontanelle, may need imaging to evaluate the underlying bone and may require surgical consultation. It is generally considered normal when your baby has a small aplasia cutis area on the scalp that is healing with basic wound care. However, you should contact your pediatrician promptly if the ACC area is bleeding heavily and the bleeding does not stop with gentle pressure — seek emergency care.
Normal vs. Concerning
By Age
What to expect by age
0-1 month
At birth, the aplasia cutis area may appear as a raw, red patch, a shallow ulcer, or a thin membrane-covered area on the scalp. Your medical team will assess the size and depth. Small, superficial defects (which are the vast majority) are managed with gentle wound care — keeping the area clean and protected. Larger or deeper defects, particularly those overlying a fontanelle, may need imaging to evaluate the underlying bone and may require surgical consultation.
1-3 months
Small ACC defects typically heal within the first few weeks to months. The area forms a smooth, flat, hairless scar. During healing, it is important to keep the area clean and protect it from trauma. Your pediatrician will monitor healing progress. If the area is not healing as expected, or if there are signs of infection (increasing redness, swelling, drainage), medical evaluation is needed.
3-12 months
By this age, most small ACC defects have fully healed. The resulting scar will be hairless, which becomes more noticeable as surrounding hair grows in. If the defect was associated with other findings (limb abnormalities, other skin lesions), your doctor may recommend genetic evaluation to check for associated syndromes such as Adams-Oliver syndrome.
1 year+
The hairless scar from ACC is permanent but usually small and easily covered by surrounding hair. For larger or more noticeable scars, cosmetic options like tissue expansion or scar revision can be discussed with a plastic surgeon when the child is older. Hair transplantation is another option for mature patients. Functionally, most children with isolated ACC have no long-term health implications.
What to Tell Your Pediatrician
- Describe when you first noticed was born with a raw spot on their scalp (aplasia cutis) and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if the ACC area is not healing or seems to be getting larger.
- Mention if there are signs of infection — redness spreading beyond the wound, swelling, discharge, or fever.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Your baby has a small aplasia cutis area on the scalp that is healing with basic wound care
- The area has formed a clean, flat scar and surrounding skin is healthy
- Your baby has an isolated small ACC with no other associated findings
- The ACC area is not healing or seems to be getting larger
- There are signs of infection — redness spreading beyond the wound, swelling, discharge, or fever
- Your baby has other skin or limb findings in addition to the scalp defect
- The defect is larger than a coin or is located over the fontanelle or midline
- The ACC area is bleeding heavily and the bleeding does not stop with gentle pressure — seek emergency care
- The area shows signs of serious infection — fever, spreading redness, pus, or your baby seems unwell
- The defect is large, deep, or overlies a fontanelle — urgent evaluation by a pediatric surgeon or dermatologist is needed
What You Can Do at Home
- Keep track of when you notice was born with a raw spot on their scalp (aplasia cutis) — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that your baby has a small aplasia cutis area on the scalp that is healing with basic wound care — this is generally within the range of normal.
- At 0-1 month, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Use fragrance-free, hypoallergenic products on your baby's skin. Avoid over-bathing — 2-3 baths per week is usually sufficient.
- While monitoring at home, seek immediate care if the ACC area is bleeding heavily and the bleeding does not stop with gentle pressure — seek emergency care.
Related Conditions
My Baby Has a Waxy Yellowish Patch on Their Scalp (Nevus Sebaceous)
A nevus sebaceous (also called nevus sebaceous of Jadassohn) is a benign birthmark that typically appears on the scalp as a flat or slightly raised, yellowish-orange, waxy or velvety patch where hair does not grow. It is present at birth and occurs in about 0.3% of newborns. During childhood, it remains relatively flat and inconspicuous. At puberty, it becomes thicker and more noticeable due to hormonal stimulation. There is a small risk (historically overstated) of developing benign or rarely malignant tumors within the nevus later in life, so monitoring and potential removal are discussed with your dermatologist.
My Baby Has a Streaky or Velvety Raised Birthmark (Epidermal Nevus)
An epidermal nevus is a benign (non-cancerous) overgrowth of skin cells that is present at birth or appears in early childhood. It typically looks like a slightly raised, skin-colored to brownish, velvety or wart-like patch that often follows a linear or streaky pattern along the body's natural skin lines (Blaschko lines). Epidermal nevi are usually isolated and purely cosmetic. However, when they are large or extensive, they can sometimes be associated with abnormalities in other organ systems (epidermal nevus syndrome), so a thorough evaluation is recommended for larger lesions.
Related Resources
Baby Skin Conditions Guide
Visual guide to common baby skin conditions, rashes, and when to see a doctor.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is was born with a raw spot on their scalp (aplasia cutis) normal?
When should I call the doctor about was born with a raw spot on their scalp (aplasia cutis)?
When is was born with a raw spot on their scalp (aplasia cutis) normal?
What causes was born with a raw spot on their scalp (aplasia cutis)?
What should I mention to my pediatrician about was born with a raw spot on their scalp (aplasia cutis)?
Is was born with a raw spot on their scalp (aplasia cutis) normal at 0-1 month?
Is was born with a raw spot on their scalp (aplasia cutis) normal at 1-3 months?
Should I go to the ER for was born with a raw spot on their scalp (aplasia cutis)?
Does was born with a raw spot on their scalp (aplasia cutis) go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss My Baby Was Born with a Raw Spot on Their Scalp (Aplasia Cutis).
Things to mention
- Describe when you first noticed was born with a raw spot on their scalp (aplasia cutis) and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if the ACC area is not healing or seems to be getting larger.
- Mention if there are signs of infection — redness spreading beyond the wound, swelling, discharge, or fever.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- The ACC area is not healing or seems to be getting larger
- There are signs of infection — redness spreading beyond the wound, swelling, discharge, or fever
- Your baby has other skin or limb findings in addition to the scalp defect
Urgent signs to report immediately
- The ACC area is bleeding heavily and the bleeding does not stop with gentle pressure — seek emergency care
- The area shows signs of serious infection — fever, spreading redness, pus, or your baby seems unwell
- The defect is large, deep, or overlies a fontanelle — urgent evaluation by a pediatric surgeon or dermatologist is needed
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of was born with a raw spot on their scalp (aplasia cutis) are normal. Talk to your pediatrician if the acc area is bleeding heavily and the bleeding does not stop with gentle pressure — seek emergency care.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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My Baby Has a Waxy Yellowish Patch on Their Scalp (Nevus Sebaceous)
A nevus sebaceous (also called nevus sebaceous of Jadassohn) is a benign birthmark that typically appears on the scalp as a flat or slightly raised, yellowish-orange, waxy or velvety patch where hair does not grow. It is present at birth and occurs in about 0.3% of newborns. During childhood, it remains relatively flat and inconspicuous. At puberty, it becomes thicker and more noticeable due to hormonal stimulation. There is a small risk (historically overstated) of developing benign or rarely malignant tumors within the nevus later in life, so monitoring and potential removal are discussed with your dermatologist.
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An epidermal nevus is a benign (non-cancerous) overgrowth of skin cells that is present at birth or appears in early childhood. It typically looks like a slightly raised, skin-colored to brownish, velvety or wart-like patch that often follows a linear or streaky pattern along the body's natural skin lines (Blaschko lines). Epidermal nevi are usually isolated and purely cosmetic. However, when they are large or extensive, they can sometimes be associated with abnormalities in other organ systems (epidermal nevus syndrome), so a thorough evaluation is recommended for larger lesions.
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