Whiteheads on a newborn: what parents should know

Milia are tiny pearly bumps caused by trapped keratin near the skin surface. They commonly appear on a newborn’s face, especially around the nose, cheeks, or eyelids, and do not behave like inflamed acne. Newborn rashes can have other causes, so note whether the skin is red, blistered, crusted, wet, or spreading.

Clean gently with water and a mild fragrance-free cleanser, then pat dry. Leave the bumps alone and avoid pinching, scraping, thick oils, exfoliants, topical retinoids, and over-the-counter acne treatments unless a clinician specifically advises them. Keep nails short and use soft fabrics so rubbing does not injure delicate skin. Most uncomplicated milia settle without extraction.

Contact a clinician promptly if the baby has fever, seems unusually sleepy or unwell, feeds poorly, or develops blisters, pus, marked swelling, warmth, bleeding, or rapidly spreading redness. Arrange an examination if the bumps persist, change, or involve the eyes, or if you cannot tell whether they are milia or another newborn rash.

Ask what the bumps look like on examination, which cleanser is suitable, whether any product should be stopped, and which changes would require same-day medical advice.