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It's 2am and you're looking at a newborn skin rash you have never seen before. RCH says rashes are very common in babies and children, and that most viral ones are harmless and go away on their own, and that sometimes a rash is a sign of a serious condition. All three are true, and none of them tells you whether to ring someone.
This isn't another list of newborn skin conditions. Our guide to what is normal in newborn skin does that job. This one is about telling them apart: which patterns mean nothing, which mean a doctor, which mean the emergency department, and the small number that mean an ambulance.
What does a newborn skin rash look like?
The newborn rashes parents see most often are blotchy red or pink marks, small white or yellow bumps, or tiny clear or red heat bumps, and in a baby who is otherwise well the common ones described below resolve without treatment. The ones that matter look different: spots that stay visible under a pressed glass, blisters or a cluster of small fluid-filled spots, honey-coloured crusts, scalded-looking skin, or any rash in a baby who is not themselves. Blisters in a baby under three months mean the emergency department straight away, and the tiers below cover the rest. If you're not sure which you're looking at, treat it as the more urgent one.
Rashes also look different on different skin tones, which healthdirect notes. The glass test below turns on whether the rash disappears under a firmly pressed drinking glass, which is how the Royal Children's Hospital clinical practice guideline on petechiae and purpura puts it.
The question that sorts most newborn rashes
The clinical sources come back to the same thing, and it isn't the rash. It's the baby.
DermNet's description of toxic erythema of the newborn, which it names alongside miliaria as the two most common, ends on a five-word sentence: the infant is otherwise well. The Royal Children's Hospital builds its whole rashes guidance the same way. Its advice branches on whether the child has a fever, whether the rash blanches, and whether they seem unwell, not on what the spots look like.
A blotchy rash that fades under a pressed glass, on a baby who is feeding, waking and settling normally, is very rarely urgent. Skin across the body that looks pale, blotchy, grey or blue is a different thing from a rash: call 000. The same rash on a baby who is floppy, hard to rouse, off their feeds or running a temperature is a different situation, and the spots have not changed at all.
RCH puts the last piece plainly on its fever page: you know your child best, and if they seem very unwell and you are worried, speak to a doctor whatever their age. If you feel your baby is very unwell, don't wait for a GP appointment: call 000 or go straight to the emergency department.
The common newborn rashes, and what each one means
Our newborn skin guide covers what each of these looks like. What follows is what each one means, which is a different question.
- Toxic erythema of the newborn, also called erythema toxicum. Blotchy red marks with small pale bumps or pustules. DermNet records it in as many as half of all full-term newborns, usually starting in the first few days and sometimes as late as two weeks, often on the face before the trunk and limbs, and it does not usually touch the palms and soles. Individual spots rarely last more than a day. DermNet calls it benign and says it requires no treatment, while adding that a number of differential diagnoses should be considered. How it arises, DermNet says, is unknown. Spots that turn into blisters, or a cluster of small fluid-filled spots, are not this rash: in a baby under three months, go to the emergency department straight away. Sores that weep or crust, or a rash that first appears after two weeks, need a GP the same day, and a fever or a baby who seems unwell follows the tiers below.
- Milia. DermNet describes a milium as a small cyst containing keratin, the skin protein, showing as tiny pearly-white bumps just under the surface of the skin. It puts neonatal milia on 40 to 50 per cent of newborn babies, often on the nose but also more widely on the scalp, face and upper trunk, healing on their own within a few weeks of birth. If you notice a coloured rash or crusting around the spots, see your GP. Pus or spreading redness needs a doctor the same day. If your baby has a fever or seems unwell, follow the tiers below.
- Baby acne, known clinically as neonatal cephalic pustulosis. Small red pimples on the face or scalp, often turning up around the third week. DermNet links it to malassezia, a yeast commonly found on skin, rather than to anything you have done, and notes it generally clears without treatment. Unlike true neonatal acne, DermNet adds, there are no blackheads or whiteheads. New pimples that first appear after six weeks are worth a GP visit this week. Spots that spread, weep or crust need a doctor the same day. If your baby has a fever or seems unwell, follow the tiers below.
- Heat rash, or miliaria. Tiny clear or red bumps where sweat ducts have blocked. DermNet reports it in about 15 per cent of newborns in warm climates, most often on the forehead, neck and upper trunk, settling within a few days once the baby is cooled down and the extra layers come off. It's a message about temperature rather than about skin. A hot baby with a fever is not just heat rash: press a glass on any spots and follow the fever tiers below, which send a baby under three months with a temperature of 38 degrees or more to the emergency department. Pus-filled lumps or spreading redness need a GP the same day. Limpness, very few wet nappies or sunken eyes in a hot baby: call 000.
- Stork bites, known clinically as naevus simplex. Flat pink or red patches, most often on the nape of the neck, the eyelids or between the brows. DermNet notes they redden with crying or straining, and that on most body sites they fade and disappear within the first one to two years. A nape patch is the exception, and DermNet gives it a 50 per cent chance of persisting indefinitely. They blanch when you press them, which matters when you get to the glass test below. A mark that is darker, thicker, raised or growing, a forehead or eyelid mark that has not faded by around age two, or a mark low on the back with a tuft of hair or a dimple, is worth a GP visit.
In a baby who is otherwise well, none of the above changes the escalation plan. Heat rash settles once the baby is cooled, and the sources describe the rest as needing no treatment. Cradle cap belongs on this list too, and our newborn skin care guide covers it, so it isn't repeated here. Eczema is a different condition again, and our baby eczema guide is where it lives.
The patterns that change the plan
A small number of newborn rashes are caused by infection, and those are worth learning by shape rather than by colour.
- Honey-coloured crusts. RCH describes impetigo, or school sores, as sores that often look like blisters, then weep, then dry to a tan or yellow crust as if covered in honey. It's bacterial, it's very contagious, and RCH says it usually needs antibiotics and will not usually clear on its own. RCH's own tiers on that page send a child who becomes unwell to hospital and sores that are spreading or getting worse during or after antibiotic treatment to a doctor, and its care advice sets the first appearance: take your child to see their doctor if you think they have impetigo. For a newborn, this article makes that a GP visit the same day. Blisters in a baby under three months are different: go to the emergency department straight away. A baby under three months who also has a fever goes to the emergency department now, and a baby who also seems unwell, such as floppy, drowsy, hard to wake or not feeding, needs 000 or the emergency department straight away.
- Grouped blisters on a red base. DermNet describes herpes simplex and chickenpox in newborns as clusters of small blisters on reddened skin that turn to pustules and then crusted sores, with herpes simplex most often on the face and scalp. It also records that a first chickenpox infection in a newborn carries a high mortality rate, and that newborns can develop disseminated herpes simplex. Neither DermNet nor RCH's parent-facing pages attach a routing tier to this pattern, so the tier here is this article's own rather than a guideline's: in a baby under three months, go to the emergency department straight away rather than waiting for a GP appointment, and in an older baby see a doctor the same day. On eczema-affected skin, a cluster of small blisters or punched-out sores can be eczema herpeticum, and at any age that means the emergency department straight away. Use the tiers below if there is also a fever or a rash that does not blanch, and call 000 if the baby is floppy, drowsy, hard to wake, not feeding or seems very unwell.
- Skin that looks scalded or burnt. RCH lists a rash with red, blistering skin that looks like a burn or a scald as a reason to go to a hospital. Red skin that looks scalded, blisters or peels off in sheets is an emergency, with or without a fever: call 000.
- Chickenpox exposure. RCH advises that babies under three months should see a GP if they could have been exposed to chickenpox, because they may need treatment. Exposure alone is enough to make the call; you don't wait for a rash.
When to get help: 000, hospital or GP
The first three tiers below come from RCH Kids Health Info's rashes guidance, reviewed November 2025, with the fever thresholds and two ambulance triggers from its fever guidance, reviewed March 2026. RCH writes for babies and children rather than newborns specifically, so where this article sends a baby under three months somewhere more urgent than RCH does, it says so, and the last three blocks, the GP visit today, the GP visit this week and the nurse line, are not RCH's either. If you're not sure which tier your baby fits, treat it as the more urgent one, and call 000 if your baby seems very unwell.
Call 000 or go straight to the emergency department
RCH says call an ambulance if your child is unwell with a fever of 38 degrees or more and has a rash that does not turn skin colour when you press it. The same applies to a rash with a fever plus headache, stiff neck or back pain, and to a rash with signs of a severe allergic reaction such as trouble breathing, wheezing or a swollen tongue. RCH's fever guidance carries its own ambulance list, and two of its triggers apply whatever the rash is doing: a child who is struggling to breathe, blue or very pale, and a child you cannot wake.
For a baby under three months, this article goes further than RCH. Call 000 if a rash that does not fade under a pressed glass is spreading or looks like purple bruises, or comes with a fever, drowsiness, floppiness, poor feeding, a high-pitched cry, or a baby who seems unwell in any way. From three months, call 000 if a rash that does not fade under a pressed glass is spreading, or comes with a fever and a baby who seems unwell; a purple, bruise-like rash in a baby who seems well means the emergency department now. At any age, call 000 for blue or grey lips, tongue or face, a baby who suddenly turns pale, blue or grey, or skin on the body that looks pale, blotchy, grey or blue, without waiting to see whether warming helps. In babies with darker skin the change can look grey or white rather than blue, so check the lips, tongue and nail beds. healthdirect lists pale, blotchy or blue skin as a reason to call 000.
At any age, with or without a fever, call 000 or go straight to the emergency department if a baby with a rash is floppy, drowsy, hard to wake or not themselves, is not feeding, can't be comforted or has a weak, high-pitched or unusual cry, is having trouble breathing, has a stiff neck or a seizure, or if you feel something is seriously wrong. The same goes for red skin that looks scalded, blisters or peels off in sheets, with or without a fever.
Go to the emergency department now
RCH lists three rash situations here: a fever with a bright-red spotty rash, a purple blotchy rash that looks like a bruise and does not blanch, and a rash with red blistering skin that looks like a burn or a scald. Its fever guidance adds a baby under one month old with a temperature above 38 degrees, and lists a non-blanching rash in a feverish child here too, where the rashes guidance sends the same presentation to an ambulance. This article follows the more urgent of the two. It goes further than RCH on skin that looks scalded, which is an emergency at any age, with or without a fever: call 000.
For a baby under three months, this article adds three situations to this tier, each its own routing rather than RCH's parent sheet, and none of them should wait for a GP appointment:
- A fever of 38 degrees or more, even if the baby seems well. healthdirect advises taking a baby under 3 months with a fever to the nearest hospital emergency department immediately.
- A rash that does not fade under a pressed glass, even with no fever and a baby who seems well. RCH's clinical guideline on petechiae and purpura says any newborn with petechiae should be promptly reviewed with a senior clinician.
- Blisters or a cluster of small fluid-filled spots, straight away.
At any age, a cluster of small blisters or punched-out sores on eczema-affected skin, especially with a fever, can be eczema herpeticum, a herpes infection of the skin: go to the emergency department straight away. Do not wait for a GP appointment.
See a doctor as soon as possible
This tier is for a child who seems well, and RCH's own heading reads "See a doctor or health professional if". It sends a child to a doctor rather than to hospital for a non-blanching rash where the child seems otherwise well and has no fever, and for a fever with a rash that does blanch. For a baby under three months, this article moves both up to the hospital tier above. For an older baby, read this tier as a doctor the same day rather than a routine booking, and if no GP can see your baby within hours, go to the emergency department.
healthdirect also says to see a doctor if a rash is not getting better by itself, is spreading or is getting worse, and RCH's own list ends with being worried about your child's rash for any reason. Worth noting: healthdirect is more cautious than RCH here and says to see your doctor urgently for any child with a fever and a rash at the same time, without splitting on whether it blanches. Where two sources differ, take the more cautious one.
See a GP today
This tier is not RCH's either. It means a GP or an after-hours GP today, for a baby who is otherwise well with honey-coloured crusts, pus or weeping sores, spots that spread, weep or crust, pus-filled lumps or spreading redness around spots, or a rash that first appears after two weeks of age. The nurse lines below can help you find one. If a sign from any tier above appears, act on that tier.
Book a GP visit this week
A rash that simply isn't improving in a baby who is otherwise well, new pimples that first appear after six weeks, a coloured rash or crusting around milia, or a birthmark that is darker, thicker, raised or growing, or sits low on the back with a tuft of hair or a dimple. If a sign from any tier above appears in the meantime, act on that tier.
If you want to talk to someone first
This one is not RCH's: its own fourth block is looking after your child at home. It is here because the option exists at any hour. In Victoria, NURSE-ON-CALL is on 1300 60 60 24 and the Maternal and Child Health Line is on 13 22 29, while outside Victoria the equivalent nurse line is healthdirect on 1800 022 222 in most states, each answered by a nurse 24 hours a day. It is not a substitute for any tier above: if a sign from one of them is present, act on that tier first.
Meningococcal infection: what RCH tells parents to look for
Most parents have heard of it. Few have been shown it properly, so here it is in RCH's own terms.
The rash RCH describes is small bright red spots or purple spots or unexplained bruises that do not turn skin-coloured, or blanch, when you press on them with a finger. RCH adds that you could also press the side of a clear drinking glass over the rash and watch to see if it blanches through the glass. This is why the stork-bite detail above matters: a birthmark or a common newborn rash blanches, and this does not.
The sentence that matters most for a newborn is the one that gets left out. RCH states that in babies, the typical symptoms may be harder to detect. The signs it lists for babies are a temperature above 38 degrees, a high-pitched moaning cry, being irritable or unsettled, refusing or not waking for feeds, vomiting, being difficult to wake or floppy, pale or blotchy skin, and the non-blanching rash.
On what to do, RCH is unambiguous. Anyone showing signs of meningococcal infection needs to immediately see a doctor or be taken to the nearest hospital emergency department. RCH also says that if your child is sent home and becomes worse or does not improve, take them straight back. RCH records that these infections can cause life-long disabilities, or death in about one in 10 people affected.
Note the rash is not the entry ticket. A baby with any of those signs and no rash at all still needs to be seen straight away, not at a routine appointment. Call 000 if they are floppy, drowsy or hard to wake, refusing or not waking for feeds, can't be comforted, have a high-pitched or unusual cry, or are pale or blotchy, and otherwise go to the emergency department straight away.
How to describe a rash to your GP
You don't need to name the rash. You need to answer the four questions the guidance itself turns on.
- Does it blanch? Press a clear glass over it and say what happened. This is the single most useful thing you can bring to the call.
- Is there a fever? An actual measured temperature, taken under the arm with a digital thermometer for a baby under three months, not a hand on a forehead. The fever thresholds above all sit at 38 degrees, but a low temperature matters too. In a baby under one month, a temperature below 36.5 degrees, or a back or tummy that feels cold, means 000 or the emergency department straight away, even if they seem well. From one to three months, do the same if a low temperature comes with any sign of being unwell. If the baby seems their usual self, warm them, check again within the hour, and go to the emergency department if it is still low, or sooner if you are worried or anything changes. Babies with a serious infection do not always have a fever.
- How is the baby otherwise? Feeding, waking, alertness, tone, cry. This carries more weight than the rash.
- What has it done and where? Where it started, where it has spread, how fast, and whether it is flat, raised, blistered or crusted.
Take a photo in good daylight, particularly if the rash comes and goes. Toxic erythema can shift within a day, so what worried you may have moved by the time you are seen.
What to do while you wait
RCH's home-care advice covers a blanching rash in a child who seems well. Most viral rashes get better on their own, antibiotics do nothing for them, and a rash from an irritant will usually go once the irritant does.
RCH also names two things you can do. If you think the rash has come from washing liquid, it suggests changing the liquid you use to wash your baby's clothes. If the rash is itchy or making your baby miserable, it says to speak with a pharmacist about treatment options. That page is written for babies and children generally, so tell the pharmacist exactly how old your baby is before you act on anything they suggest.
RCH's home-care block also carries a referral: you should speak with your child's doctor if you think they have an allergy. Note anything that changes. If a sign from the tiers above appears, act on that tier rather than waiting, and if you're unsure at any hour, ring the nurse line or go up a tier.
Common questions about newborn skin rashes
Is a newborn skin rash normal?
Usually, yes. Toxic erythema of the newborn, which DermNet names alongside miliaria as the two most common, appears in as many as half of all full-term babies and needs no treatment. What separates a normal rash from one that needs attention is generally not the rash itself but whether the baby is otherwise well. It is not normal if the rash doesn't fade under a pressed glass, if it blisters, or if your baby has a fever or seems unwell: the tiers above say where to go.
What is the glass test for a rash?
RCH describes pressing the side of a clear drinking glass over the rash and watching to see if it blanches, meaning turns skin-coloured, through the glass. Spots that stay visible are non-blanching. RCH says call an ambulance on 000 if a child is unwell with a fever of 38 degrees or more and a rash that does not blanch. In a baby under three months, spots that stay visible mean the emergency department straight away, even with no fever, and 000 if the rash is spreading or looks like bruises, or your baby has a fever or seems unwell.
My newborn has a rash but seems fine. Do I still need a doctor?
If the baby is feeding, waking and behaving normally, has no fever, and the rash blanches, RCH's advice is that they can usually be looked after at home. A non-blanching rash is different even when the baby seems well and has no fever: under three months, go to the emergency department straight away rather than waiting for a GP appointment, and over three months see a doctor the same day. A fever of 38 degrees or more in a baby under three months also means the emergency department, whatever the rash is doing.
When to see your GP
See a GP the same day for a rash that is spreading, weeping or crusting, and book a GP visit for one that simply isn't improving in a baby who is otherwise well. Blisters in a baby under three months are not a GP booking: go to the emergency department straight away. A rash that does not blanch is never a routine appointment either: under three months, go to the emergency department straight away even if your baby has no fever and seems well, and over three months see a doctor the same day. For anything in between, ring your MCHN or a nurse line, NURSE-ON-CALL on 1300 60 60 24 in Victoria or healthdirect on 1800 022 222 in most other states.
Call an ambulance on 000 if a rash that does not blanch comes with a fever, is spreading or looks like bruises, or your baby seems unwell, and for blue or grey lips, skin that looks pale, blotchy or blue, or a baby who is floppy, drowsy or hard to wake. The rest of the ambulance and hospital triggers sit with the tiers above.
Trust your instinct, which is RCH's own advice on its fever page: you know your child best. If what you still want is a description rather than a decision, our guide to what is normal in newborn skin covers what each of these rashes looks like.