Neonatal Cephalic Pustulosis - Causes, Symptoms, and Treatment

What Is Neonatal Cephalic Pustulosis?

Neonatal cephalic pustulosis is a common skin condition in babies in which inflamed lesions or red spots appear on the cheeks, nose, forehead, neck, shoulder, and other parts of the body. The other name for neonatal cephalic pustulosis is benign cephalic pustulosis, cephalic pustulosis, and transient cephalic neonatal pustulosis. It occurs during the first four weeks after birth, and around 20 percent of babies get neonatal cephalic pustulosis. It is often a temporary condition and resolves on its own, without any treatment, within seven days. The prognosis of this skin condition is usually excellent, with no adverse outcomes anticipated.

What Are the Causes of Neonatal Cephalic Pustulosis?

The exact cause of neonatal cephalic pustulosis is currently unknown, but it is believed by some experts that exposure to maternal hormones during pregnancy period plays an important role in causing neonatal cephalic pustulosis. As this skin condition is seen predominantly in boys than girls, it is considered that elevated infant androgens (male hormones) may be responsible for this condition.

Some research suggests that neonatal cephalic pustulosis may be linked to Malassezia colonization. Malassezia is a type of fungi that occurs naturally s the human skin. It is believed that an inflammatory reaction with Malasseziayeast may be a cause. A study involving the microscopic examination of pustules showed the presence of Malassezia furfur, and another species, Malassezia sympodialis, was majority seen in severe cases of neonatal cephalic pustulosis and not in mild or moderate cases. However, the exact relationship between neonatal cephalic pustulosis and Malassezia is not well understood.

Neonatal cephalic pustulosis was once considered to be caused by maternal hormonal stimulation of sebaceous glands. Other causes of neonatal cephalic pustulosis include allergic reactions, sensitive skin irritated by milk, formula, or spit-up, viral illnesses, and certain medications. Also, there is no known systemic disorders or conditions were observed to cause neonatal cephalic pustulosis.

What Are the Symptoms of Neonatal Cephalic Pustulosis?

Neonatal cephalic pustulosis is temporary and usually develops within four weeks after birth and lasts for several days or weeks. In rare cases, they can even last for several months. The signs and symptoms of neonatal cephalic pustulosis include:

• Presence of several tiny red pimple-like skin eruptions, which may present as a rough and bumpy rash.

• These appear in the form of small white papules and pustules.

• Whiteheads and blackheads, known as comedones and nodules, may not be seen.

• The common spot for neonatal cephalic pustulosis is the cheeks and forehead, but it can also be noted anywhere on the face, scalp, shoulder, and neck.

• There can be aggravation of the symptoms by saliva or vomit on the face and by using rough clothes.

• Usually, neonatal cephalic pustulosis may not be painful and does not cause itching or scarring.

What Is the Treatment for Neonatal Cephalic Pustulosis?

Neonatal cephalic pustulosis is a temporary condition, so treatment is mostly not required, as it goes away without any specific treatment. However, for severe cases, a healthcare provider may consider treatment. So, the treatment for neonatal cephalic pustulosis may include the following:

• Wait and watch measures.

• Use of antifungal creams such as Ketoconazole creams.

• A low-potency steroid like Hydrocortisone.

The prescribed medicines can be applied to the baby's skin as instructed by healthcare professionals. Avoid any OTC (over-the-counter) creams or lotions for acne in children because the condition may get worse without proper guidance.

What Home Remedies Will Help Reduce Neonatal Cephalic Pustulosis?

It is important to contact the baby's healthcare provider before applying any products to the baby's acne because even home remedies can irritate the baby's delicate skin. By following simple, the baby's skin can be taken care of at home. This may include:

• Cleaning the baby's face daily - Gently wash the baby's skin with warm water. Do not scrub their skin. Then, pat the baby's skin dry. Alternate between using warm water one day and warm water with mild facial soap the next day.

• Do not use oils or lotions on the baby's skin or any products that may clog the pores.

• Clean up milk or vomit from the baby's skin immediately.

• Do not pinch or scrub the acne, as it can lead to more irritation or infection.

• Avoid vigorous washing and scrubbing, which may exacerbate the problem.

If the neonatal cephalic pustulosis is not going away or worsens after a couple of weeks, it is important to contact a healthcare provider.

What Is the Differential Diagnosis of Neonatal Cephalic Pustulosis?

The differential diagnosis of neonatal cephalic pustulosis includes:

• Miliaria Rubra - They are a mild form of heat rashes. They look similar to benign cephalic pustulosis but occur more on skin folds like the neck and areas exposed to occlusion or heat.

• Milia -Milia are little white bumps rather than erythematous, which more often appear in the nose. They will not pop like pimples because they are little cysts and are not filled with pus.

• Congenital Candidiasis - This type of rash is more widespread than neonatal cephalic pustulosis and may be liked with infection of the mother, placenta, or umbilical cord.

• Eosinophilic Pustular Folliculitis - They have scalp involvement, are pruritic, and rapidly crust over.

• Staphylococcal Folliculitis - They are more widespread and usually occur in moist and occluded areas.

• Keratosis Pilaris - They have a rough surface.

• Eczema - They are patchy and have more scales.

• Nevus Comedonicus – They are unilateral and linear.

• Scabies - Scabies are more widespread and pruritic.

• Erythema Toxicum Neonatorum - This type of rash is more widespread and transient than neonatal cephalic pustulosis. Each bump has more of a blush around the back of it.

Does Breastfeeding Cause Neonatal Cephalic Pustulosis?

Hormones from a mother's breast milk can affect the newborn's hormones, leading to acne. Neonatal cephalic pustulosis is a temporary skin condition that clears up without medical treatment. This should not affect how a mother breastfeeds their newborn, as neonatal cephalic pustulosis will go away as the baby grows and adjusts to the new environment.

Conclusion

Neonatal cephalic pustulosis can be distressing for parents, but it does not cause any serious impact on the infant, as they are not painful; also, it will go away on its own without any scarring. It is always good to consult a pediatrician if parents are concerned and know the best way to treat their baby's acne.