Red Spots on Infant Skin: Causes and Concerns

Red spots on infant skin

My daughter is over three months old, and I noticed three or four small red spots on her face in the past couple of days.
They are flat and seem not to itch (she hasn't scratched them).
I'm not sure if this is related to anything.
Additionally, I have a keloid tendency, so I would like to ask how long it takes for the scar from the BCG vaccine to fade.
If it doesn't fade, does that mean she has a keloid tendency as well? Thank you!

Li, 30~39 year old female. Ask Date: 2002/12/03

Dr. Liang Hongjian reply Pediatrics

There are several possible causes for red spots on the face.
The first is neonatal eczema, which is also the most common issue.
It is important to assess the family history of allergies to determine if this is a possibility.
Additionally, insect bites, particularly from mosquitoes, are common; if there is no significant reaction, it may only present as small red spots.
Since there is currently no pain or itching, it is advisable to observe the spots for a few days and consult a dermatologist or your family physician if you notice any abnormalities.
Furthermore, the etiology of keloids is unknown, but there may be a familial tendency.
They are rare in infants and are more commonly discovered during adolescence or after the age of 30.
Generally, the BCG vaccine will produce a reaction three to four weeks after administration, and the skin will form a scab that may leave a scar, which will gradually fade over time without a specific time limit.

Reply Date: 2002/12/03

More Info

When it comes to red spots on an infant's skin, there are several potential causes that parents should be aware of. Given that your daughter is just over three months old and has developed a few small, flat red spots on her face that do not seem to itch or cause her discomfort, it is important to consider a few common dermatological conditions that could be responsible for these symptoms.

One possibility is that these red spots could be related to a benign condition known as "milia," which are small white or red bumps that often appear on the faces of infants. They are caused by trapped keratin beneath the skin's surface and typically resolve on their own without any treatment. Another common condition in infants is "neonatal acne," which can present as small red bumps or pustules on the face, often appearing around the cheeks and forehead. This condition is also self-limiting and usually clears up within a few months.

Another possibility is an allergic reaction or irritation, which can occur due to various factors such as new skincare products, laundry detergents, or even certain fabrics. If you have recently introduced any new products to your baby's routine, it may be worth considering whether they could be contributing to the skin changes.

In terms of your concern about keloids (or "crab foot" as you referred to it), it is important to note that keloids are a type of raised scar that can occur after skin injury. They are more common in individuals with a predisposition to keloid formation, which can be genetic. The BCG vaccine (Bacillus Calmette-Guérin) is often administered to infants, and it can leave a scar at the injection site. The healing time for this scar can vary, but it typically takes several weeks to months to mature. If the scar does not fade or if it becomes raised and thickened, it may indicate a keloid formation. However, the mere presence of a scar does not necessarily mean that your child will develop keloids in the future.

If you are concerned about the red spots on your daughter's face or the healing of the BCG vaccination site, it is advisable to consult with a pediatric dermatologist. They can provide a thorough examination and determine whether any treatment is necessary. In most cases, benign skin conditions in infants do not require aggressive treatment and will resolve on their own.

In summary, while the red spots on your infant's skin could be due to a variety of benign causes, it is always best to err on the side of caution and seek professional advice if you have concerns. Monitoring the spots for any changes in size, color, or discomfort is also important. As for the BCG vaccination scar, patience is key, and if you notice any unusual changes, a consultation with a healthcare provider can provide peace of mind.

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