Case of the Month with Crutchfield Dermatology

By Charles E. Crutchfield III, MD
Wednesday, December 18, 2019

A newborn baby has periods of erythema covering half of her face/head.

These periods of hemicephalic erythema occur on both sides of the face/head in the same baby. They can last a few seconds to a few minutes and then completely disappear! They can occur at any time but occur most commonly when the baby is lying down, on the dependent side of the head.

Diagnosis: Harlequin color change — unilateral transient hemifacial erythema in a newborn

Charles E. Crutchfield III, MD

Amazingly, this odd half-head, ephemeral flushing reaction has been reported to occur in 10% of all newborns. The condition is harmless and is not a harbinger of any other health concerns. The condition usually appears in the first few days of life and almost always resolves within four weeks, if not sooner, without any additional appearances or complications. The condition can occur on both sides of the head in the same newborn, as it did in this patient.

The exact cause is uncertain, but noted, board-certified dermatologist, Neil Shah, MD, of Minnesota believes it is a result of a slightly immature autonomic nervous system that rapidly catches up in a few days or weeks after birth, resulting in a complete disappearance of the condition. No additional work-up is required.

For more information, contact Charles E. Crutchfield III, MD, at Crutchfield Dermatology or visit