Skin & Rashes

Erythema Toxicum (Red Blotchy Rash in Newborns)

Medically reviewed by Dr. Sarah Chen, MD, FAAP · Board-Certified Pediatrician

Content reviewed against published AAP, NIH guidelines

Editorial policy

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Baby skin is sensitive and changes frequently. If you are noticing erythema toxicum (red blotchy rash in newborns), here is what you need to know.

The short answer

Erythema toxicum is a very common, completely harmless rash that appears in up to 50% of full-term newborns, usually within the first 2-5 days of life. It looks like red blotches with small yellow or white bumps and can appear anywhere on the body except the palms and soles. It resolves on its own without any treatment.

Key takeaways

  • Erythema toxicum is a very common, completely harmless rash that appears in up to 50% of full-term newborns, usually within the first 2-5 days of life. It looks like red blotches with small yellow or white bumps and can appear anywhere on the body except the palms and soles. It resolves on its own without any treatment.
  • Usually normal when: Red blotchy patches with or without small white or yellow bumps appearing in the first few days of life
  • Call your doctor if: Rash appears with fever, poor feeding, irritability, or lethargy, which could indicate infection
  • Varies by age — see the age-by-age breakdown below
“Eczema is very common in babies and children. About 1 in 10 children will develop eczema, typically starting in the first few months of life.”
— Eczema in Babies and Children, American Academy of Pediatrics (AAP)

Parents everywhere have the same worry. You are doing the right thing by looking into it.

What Parents Should Know

According to AAP, NIH guidelines, erythema toxicum is a very common, completely harmless rash that appears in up to 50% of full-term newborns, usually within the first 2-5 days of life. It looks like red blotches with small yellow or white bumps and can appear anywhere on the body except the palms and soles. It resolves on its own without any treatment. At 0-1 month, erythema toxicum typically appears between 24 and 72 hours after birth, though it can occur anytime in the first two weeks. The rash consists of red, blotchy patches that may have a small yellow or white bump (pustule) in the center, sometimes described as looking like flea bites. It can appear on the face, trunk, arms, and legs but spares the palms and soles. The rash comes and goes, moving to different areas of the body. It does not bother your baby and needs no treatment. It usually clears within 5-14 days. It is generally considered normal when red blotchy patches with or without small white or yellow bumps appearing in the first few days of life. However, you should contact your pediatrician promptly if rash appears with fever, poor feeding, irritability, or lethargy, which could indicate infection.

Sources: [1], [2]

Normal vs. Concerning

Usually Normal
Worth Discussing
Red blotchy patches with or without small white or yellow bumps appearing in the first few days of life
Rash appears with fever, poor feeding, irritability, or lethargy, which could indicate infection
The rash comes and goes and moves to different areas of the body
Blisters, peeling skin, or rash on the palms and soles, which may suggest a different condition requiring evaluation
Baby is otherwise well, feeding normally, and not bothered by the rash
You are unsure whether the rash is erythema toxicum or something else
The rash does not appear on the palms of hands or soles of feet
The rash persists beyond two weeks of life

By Age

What to expect by age

0-1 month

Erythema toxicum typically appears between 24 and 72 hours after birth, though it can occur anytime in the first two weeks. The rash consists of red, blotchy patches that may have a small yellow or white bump (pustule) in the center, sometimes described as looking like flea bites. It can appear on the face, trunk, arms, and legs but spares the palms and soles. The rash comes and goes, moving to different areas of the body. It does not bother your baby and needs no treatment. It usually clears within 5-14 days.

1-3 months

Erythema toxicum should have resolved by this age. If your baby develops a new rash during this period, it is likely a different condition. Common rashes at this age include baby acne, heat rash, or eczema. Any rash that appears with fever, poor feeding, or irritability should be evaluated by your pediatrician.

3-6 months

Erythema toxicum does not occur at this age. New rashes should be evaluated based on their appearance and any associated symptoms.

6-12 months

This rash is exclusively a newborn phenomenon. Any persistent or new skin concerns at this age should be discussed with your pediatrician.

What to Tell Your Pediatrician

  • Describe when you first noticed erythema toxicum (red blotchy rash in newborns) and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if you are unsure whether the rash is erythema toxicum or something else.
  • Mention if the rash persists beyond two weeks of life.
  • 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

Probably normal when...
  • Red blotchy patches with or without small white or yellow bumps appearing in the first few days of life
  • The rash comes and goes and moves to different areas of the body
  • Baby is otherwise well, feeding normally, and not bothered by the rash
  • The rash does not appear on the palms of hands or soles of feet
Mention at your next visit when...
  • You are unsure whether the rash is erythema toxicum or something else
  • The rash persists beyond two weeks of life
  • The bumps appear to contain cloudy or yellowish fluid
Act now when...
  • Rash appears with fever, poor feeding, irritability, or lethargy, which could indicate infection
  • Blisters, peeling skin, or rash on the palms and soles, which may suggest a different condition requiring evaluation

What You Can Do at Home

  • Keep track of when you notice erythema toxicum (red blotchy rash in newborns) — noting the time of day, duration, and any triggers can help your pediatrician.
  • Remember that red blotchy patches with or without small white or yellow bumps appearing in the first few days of life — 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 rash appears with fever, poor feeding, irritability, or lethargy, which could indicate infection.

Milia (Tiny White Bumps on Baby's Face)

Milia are tiny white or yellowish bumps (about 1-2mm) that appear on a newborn's nose, cheeks, chin, and forehead. They are caused by tiny keratin cysts trapped beneath the skin and are present in up to 40-50% of newborns. They are completely harmless and disappear on their own within a few weeks to months without any treatment.

Transient Neonatal Pustular Melanosis

Transient neonatal pustular melanosis is a harmless skin condition present at birth, appearing as small pustules that rupture easily, leaving dark brown spots (hyperpigmented macules) surrounded by a fine collarette of scale. It is more common in darker-skinned babies, is not an infection, and requires no treatment. The dark spots fade over weeks to months.

Baby Acne (Neonatal Acne)

Baby acne is a very common, harmless condition that appears as small red or white bumps on your newborn's face, usually around 2-4 weeks of age. It is caused by maternal hormones still circulating in your baby's system and clears up on its own within a few weeks to months without any treatment.

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Frequently asked questions

Is erythema toxicum (red blotchy rash in newborns) normal?
Erythema toxicum is a very common, completely harmless rash that appears in up to 50% of full-term newborns, usually within the first 2-5 days of life. It looks like red blotches with small yellow or white bumps and can appear anywhere on the body except the palms and soles. It resolves on its own without any treatment.
When should I call the doctor about erythema toxicum (red blotchy rash in newborns)?
Rash appears with fever, poor feeding, irritability, or lethargy, which could indicate infection Blisters, peeling skin, or rash on the palms and soles, which may suggest a different condition requiring evaluation
When is erythema toxicum (red blotchy rash in newborns) normal?
Red blotchy patches with or without small white or yellow bumps appearing in the first few days of life The rash comes and goes and moves to different areas of the body Baby is otherwise well, feeding normally, and not bothered by the rash
What causes erythema toxicum (red blotchy rash in newborns)?
Erythema toxicum is a very common, completely harmless rash that appears in up to 50% of full-term newborns, usually within the first 2-5 days of life. It looks like red blotches with small yellow or white bumps and can appear anywhere on the body except the palms and soles. It resolves on its own without any treatment. Common explanations include: Red blotchy patches with or without small white or yellow bumps appearing in the first few days of life. The rash comes and goes and moves to different areas of the body.
What should I mention to my pediatrician about erythema toxicum (red blotchy rash in newborns)?
You should mention erythema toxicum (red blotchy rash in newborns) at your next visit if: You are unsure whether the rash is erythema toxicum or something else. The rash persists beyond two weeks of life. The bumps appear to contain cloudy or yellowish fluid.
Is erythema toxicum (red blotchy rash in newborns) normal at 0-1 month?
Erythema toxicum typically appears between 24 and 72 hours after birth, though it can occur anytime in the first two weeks. The rash consists of red, blotchy patches that may have a small yellow or white bump (pustule) in the center, sometimes described as looking like flea bites. It can appear on the face, trunk, arms, and legs but spares the palms and soles. The rash comes and goes, moving to different areas of the body. It does not bother your baby and needs no treatment. It usually clears within 5-14 days.
Is erythema toxicum (red blotchy rash in newborns) normal at 1-3 months?
Erythema toxicum should have resolved by this age. If your baby develops a new rash during this period, it is likely a different condition. Common rashes at this age include baby acne, heat rash, or eczema. Any rash that appears with fever, poor feeding, or irritability should be evaluated by your pediatrician.
Should I go to the ER for erythema toxicum (red blotchy rash in newborns)?
Seek emergency care if rash appears with fever, poor feeding, irritability, or lethargy, which could indicate infection, or if blisters, peeling skin, or rash on the palms and soles, which may suggest a different condition requiring evaluation. When in doubt, call your pediatrician's after-hours line for guidance.
Does erythema toxicum (red blotchy rash in newborns) go away on its own?
In many cases, erythema toxicum (red blotchy rash in newborns) resolves on its own, especially when red blotchy patches with or without small white or yellow bumps appearing in the first few days of life. By 6-12 months, this rash is exclusively a newborn phenomenon. Any persistent or new skin concerns at this age should be discussed with your pediatrician.
AAPNIH

References

  1. [1]American Academy of Pediatrics. Rashes and Skin Conditions in Newborns. HealthyChildren.org. AAP
  2. [2]National Library of Medicine. Erythema Toxicum Neonatorum. StatPearls. NIH

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss Erythema Toxicum (Red Blotchy Rash in Newborns).

Things to mention

  • Describe when you first noticed erythema toxicum (red blotchy rash in newborns) and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if you are unsure whether the rash is erythema toxicum or something else.
  • Mention if the rash persists beyond two weeks of life.
  • 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

  • You are unsure whether the rash is erythema toxicum or something else
  • The rash persists beyond two weeks of life
  • The bumps appear to contain cloudy or yellowish fluid

Urgent signs to report immediately

  • Rash appears with fever, poor feeding, irritability, or lethargy, which could indicate infection
  • Blisters, peeling skin, or rash on the palms and soles, which may suggest a different condition requiring evaluation

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

Baby Skin Conditions GuideRash TriageBaby Tracker

Bottom line

Most cases of erythema toxicum (red blotchy rash in newborns) are normal. Talk to your pediatrician if rash appears with fever, poor feeding, irritability, or lethargy, which could indicate infection.

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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Milia (Tiny White Bumps on Baby's Face)

Milia are tiny white or yellowish bumps (about 1-2mm) that appear on a newborn's nose, cheeks, chin, and forehead. They are caused by tiny keratin cysts trapped beneath the skin and are present in up to 40-50% of newborns. They are completely harmless and disappear on their own within a few weeks to months without any treatment.

Transient Neonatal Pustular Melanosis

Transient neonatal pustular melanosis is a harmless skin condition present at birth, appearing as small pustules that rupture easily, leaving dark brown spots (hyperpigmented macules) surrounded by a fine collarette of scale. It is more common in darker-skinned babies, is not an infection, and requires no treatment. The dark spots fade over weeks to months.

Baby Acne (Neonatal Acne)

Baby acne is a very common, harmless condition that appears as small red or white bumps on your newborn's face, usually around 2-4 weeks of age. It is caused by maternal hormones still circulating in your baby's system and clears up on its own within a few weeks to months without any treatment.

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New Treatments for Atopic Dermatitis (Eczema) in Children

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