Neonatal Pustular Melanosis

If you’re a new mom or you’re expecting, you must have had multiple mental pictures of your precious one’s features. In fact, some expecting parents even go as far as teasing each other about who the baby would take after in terms of physical features.

However, the process isn’t always so straightforward.

Most times, a parent’s disappointment is justified when his/her baby has dark spots that look slightly weird. If you’re in these shoes, the first step is to know that it isn’t your fault nor is it your baby’s fault. Both of you are perfectly okay, it just happened.

In medical terms, these dark spots on a newborn are called transient neonatal pustular melanosis.

Neonatal pustular melanosis

Slow Down.

You don’t need to fret about the name, it’s nothing serious.

In fact, that’s why we have put this article together to shed more light on the topic and help you break down that seemingly disturbing name. In this article you will find what neonatal pustular melanosis is all about; how often it occurs, the symptoms, and the treatment plan.

Don’t Stop Reading!

What’s Transient Neonatal Pustular Melanosis?

Despite the fact that skin lesions are common in newborns, it is important that you know the difference between the clinically significant ones and the ones that aren’t.

Transient neonatal pustular melanosis is a rare non-cancerous pustular condition in newborn babies. Other doctors refer to it as transient neonatal pustulosis and transient neonatal pustular dermatosis. Although the name may sound so big and complicated, this is not the case.

Let’s break down the name.

Transient’ means to disappear with time and a ‘neonate’ is a newborn. On the other hand, a ‘pustule‘ is an accumulation of pus on the skin or a pimple filled with pus. “Melanosis’ is a deposition of melanin, a natural skin pigment or color. To add it all together, transient neonatal pustular melanosis is an accumulation of pus on the skin of a newborn due to the deposition of melanin.

Interestingly, this condition does not persist for a long time. Hence, the word ‘transient’.


Transient neonatal pustular melanosis is usually seen in newborn babies with skin of color. This condition is characterized by vesicles, pigmented macules, and superficial pustules. Furthermore, these pustules are present at birth and can be on the forehead, chin, neck, chest, back, buttocks, and sometimes, they can be on the palms and soles of the feet.

The pustules and vesicles easily resolve within 48 hours but the macules may persist for a few months.

How often does transient neonatal pustular melanosis occur?

In the United States, research has shown that transient neonatal pustular melanosis is more common among African American newborns.

It occurs at a rate of about 0.6% in white newborns and at a rate of approximately 5% in African American newborns. Generally, in the United States, the overall incidence rate is about 2.2%.

Interestingly, transient neonatal pustular melanosis has also been reported among non-African American babies with skin of color. However, there are no sufficient reports to give us a vivid percentage.

Transient neonatal pustular melanosis is more prevalent among term babies compared with preterm babies. This condition does not have a gender predisposition, as it affects male and female babies alike.

Is Neonatal Pustular Melanosis Bad?

Ignore the very long name, transient neonatal pustular melanosis is essentially harmless. Also, it shows no harmful symptoms and is self-limited. Furthermore, no baby develops other medical conditions or dies due to transient neonatal pustular melanosis.

The vesicles (boils that contain clear fluid) and pustules (boils that contain pus) associated with transient neonatal pustular melanosis resolve within 2 days after birth. They become macules (dark, flat spots on the skin), which eventually fade within one or more months.

Since this condition is benign, you can rest assured that your baby will get over it in a couple of days without developing other conditions.

What’s The Cause?

The actual cause of transient neonatal pustular melanosis is unknown.

Also, transient neonatal pustular melanosis does not run in families. So the fact that your first baby has it does not mean other babies to come will have it.

Great news, right?

Clinical Features of Transient Neonatal Pustular Melanosis

It is very important to know the clinical features of transient neonatal pustular melanosis as it helps to differentiate it from other severe conditions.

The main clinical feature of transient neonatal pustular melanosis is the presence of pustules. This can occur in any part of your baby’s body including the forehead, back of the ears, the chin, neck, chest, stomach, buttocks, thighs, palms of the hand, or the soles of the feet.

These pustules can occur singly or in clusters. As they resolve, they can rupture and crust which leaves dark spots that may eventually fade off in a couple of weeks.

In transient neonatal pustular melanosis, the pustules are present at birth and new ones do not develop after birth. This means that if there are new pustules developing on your baby after birth, you need to get him or her checked as this may not be a transient neonatal pustular melanosis.

Normally, transient neonatal pustular melanosis is not associated with any abnormal laboratory features or any other condition. Therefore, if your baby’s lab result deviates from normal or he/she has other conditions, then the pustules may not be transient.

What’s The Treatment Plan?

There is no need for medication or treatment to manage transient neonatal pustular melanosis. It is a self-resolving condition. This means that without your intervention, the pustules will resolve and clear on their own.

Also, it does not have any long-term complications whatsoever.


If your baby has transient neonatal pustular melanosis, you don’t need to be burdened or overly worried, it will resolve on its own. In a few days, your baby’s condition would likely improve.

All you have to do is breastfeed your baby well so that he or she can develop a good immune system to fight this condition.

You have nothing to worry about.


Sangita Ghosh (2015). Neonatal Pustular Dermatosis: An Overview. Indian Journal of Dermatology Mar-Apr; 60(2): 211. Accessed on 24th January, 2022 from

Barr, R. J., Globerman, L. M., and Werber, F. A. (1979). Transient neonatal pustular melanosis. International journal of dermatology, 18(8), 636–638. Accessed on 24th January, 2022 from