The appearance of pimples on both sides of the baby’s cheeks may be eczema, or it may be follicular erythema nigricans on the face and neck, or it may be neonatal acne or milia, depending on the shape of the lesions. Eczema usually appears as a red papule, sometimes with oozing and itching. Facial and cervical follicular erythema nigricans has a genetic predisposition and presents as a keratotic papule with no self-conscious symptoms. Neonatal acne is associated with maternal hormone levels and presents with a pimple-like rash. Acne vulgaris presents as a pearly white, rounded papule. The above diseases need to be differentiated and treated aggressively after a clear diagnosis.