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What is Aplasia Cutis Congenita?

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Aplasia Cutis Congenita (ACC) is a rare condition where a baby is born missing a small area of skin, usually on the scalp. Most cases are isolated with an excellent prognosis. The skin typically heals completely over a few weeks to months using simple, non-surgical wound care.

Key Takeaways

  • • Aplasia Cutis Congenita (ACC) is a rare condition where a newborn is missing top layers of skin, typically on the crown of the head.
  • • The majority of ACC cases are isolated findings and are not associated with other underlying health syndromes.
  • • The prognosis for isolated ACC is excellent, and the skin usually heals completely within a few weeks to months.
  • • Standard, non-surgical wound care using specialized dressings is the highly effective, preferred treatment for most cases.
  • • The affected area typically heals into a smooth, hairless scar because the deeper skin layers containing hair follicles are missing.

Finding a raw or open wound on your newborn’s head or body can be a deeply shocking and frightening experience [1][2]. In the quiet, high-stakes environment of a delivery room, seeing a medical team appear surprised or uncertain only adds to that panic [3][1]. It is important to know that while your baby’s skin looks different right now, this condition is a recognized medical occurrence with a well-established path forward.

What is Aplasia Cutis Congenita (ACC)?

Aplasia cutis congenita (ACC) is a rare condition where a baby is born missing a small area of skin [4][5]. While it can happen anywhere on the body, it most commonly appears on the vertex (the top or “crown”) of the scalp [6][7].

The affected area may look like a shallow, open wound, a thin membrane, or even a healed scar [8][9]. In most cases, only the top layers of skin—the epidermis (outer layer) and dermis (deeper layer)—are missing [4]. In rarer, more complex cases, the underlying bone or deeper tissues may also be affected [8].

Why is the Medical Team Surprised?

If your pediatrician or the delivery nurses seem unfamiliar with ACC, it is because the condition is rare. It occurs in only about 1 to 10 out of every 10,000 live births [4][5].

Because it is so uncommon, many standard medical practitioners may have never seen a case in person [10][6]. This lack of familiarity does not mean your baby’s condition is unmanageable; it simply means your care team may need to consult with a pediatric dermatologist (a skin specialist for children) to confirm the diagnosis and plan the next steps [10][11].

Three Stabilizing Facts for Parents

While the initial discovery of ACC is distressing, three key facts often provide immediate reassurance:

  1. Most Cases are “Isolated”: For the vast majority of babies, ACC is an isolated finding, meaning it is not connected to any other health problems or underlying syndromes [6][7]. Once the skin heals, these children typically face no further medical issues related to the condition [12][13].
  2. Excellent Prognosis: The long-term outlook (prognosis) for children with isolated ACC is highly favorable [12]. Most lesions heal completely on their own within a few weeks to a few months [14][15].
  3. Simple Care is Highly Effective: In most cases, the preferred treatment is conservative management, which is just a medical term for standard, non-surgical wound care [14][16]. Using specialized dressings to keep the area clean and moist is usually all that is needed to allow the baby’s body to repair the skin naturally [17][18].

What to Expect Next

As the area heals, it will gradually fill in with new tissue from the edges inward [14]. Small lesions may close in 2 to 4 weeks, while larger or deeper defects can take several months to fully heal [14]. It is important to note that because hair follicles are located deep within the skin layers that may be missing, the area where the ACC occurred will likely remain a smooth, hairless scar even after it has fully healed [7][19]. Your medical team will guide you on how to protect this delicate new skin as your baby grows.

For a deeper dive into why this happens, proceed to Causes and Diagnosis.

Frequently Asked Questions

What is Aplasia Cutis Congenita (ACC)?
Aplasia Cutis Congenita is a rare condition where a newborn is missing a small area of skin, most commonly on the crown of the scalp. The affected area can look like a shallow open wound, a thin membrane, or even a healed scar at birth.
Is Aplasia Cutis Congenita dangerous for my baby?
For the vast majority of babies, ACC is an isolated finding, meaning it is not connected to any underlying health problems. The long-term prognosis is excellent, and once the skin heals, children typically face no further medical issues related to the condition.
How is Aplasia Cutis Congenita treated?
Most cases are treated with conservative management, which means standard, non-surgical wound care. Your medical team will likely recommend specialized dressings to keep the area clean and moist, allowing your baby's body to naturally repair the skin.
Will hair grow over the area where the skin was missing?
Because hair follicles are located deep within the layers of skin that are missing, hair typically will not grow in that specific spot. Once the area has fully healed, it usually remains a smooth, hairless scar.
How long does it take for Aplasia Cutis Congenita to heal?
Small lesions may close in just two to four weeks. Larger or deeper defects can take several months to fully heal as new tissue gradually fills in from the edges inward.

Questions for Your Doctor

  • • Is my baby's ACC 'isolated' (Type 1), or are there signs it might be related to other conditions?
  • • What specific type of wound care and dressings do you recommend for this specific location?
  • • What signs of infection or healing should I be looking for during daily care?
  • • Are there any clinical markers, like a 'hair collar sign,' that suggest we should do further imaging?
  • • How often should we follow up with a specialist, such as a pediatric dermatologist, to monitor the healing?

Questions for You

  • • What were my first thoughts when I saw the lesion, and have I had a chance to process them with my partner or a support person?
  • • Are there any other physical findings I've noticed on my baby, such as different-looking nails or limbs, that I should mention to the doctor?
  • • How comfortable do I feel performing the recommended dressing changes on my own?

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References

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    Adams-Oliver syndrome, intestinal obstruction and heart defects: a case series of aplasia cutis congenita.

    Baroudi I, Alakhras O, Douri T, Alkhani N

    Oxford medical case reports 2022; (2022(1)):omab141 doi:10.1093/omcr/omab141.

    PMID: 35083055
  2. 2

    Surgical management of aplasia cutis congenita of the scalp and skull defect in a resource-limited setting: A case report.

    Agyekum R, Darko K, Odame NYA, et al.

    Surgical neurology international 2026; (17()):46 doi:10.25259/SNI_1245_2025.

    PMID: 41660340
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    Aplasia cutis congenita: a report of two cases from National Hospital Abuja, Nigeria and review of the literature.

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    The Pan African medical journal 2020; (36()):291 doi:10.11604/pamj.2020.36.291.24523.

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    Membranous aplasia cutis congenita.

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    Dermatology reports 2025; doi:10.4081/dr.2025.10544.

    PMID: 41246959
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    Nonsyndromic aplasia cutis congenita: a case report.

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    Journal of biological regulators and homeostatic agents 2015; (29(1 Suppl)):129-31.

    PMID: 26016981
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    A Case Series of Aplasia Cutis Congenita and Its Management.

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    Cureus 2025; (17(3)):e80135 doi:10.7759/cureus.80135.

    PMID: 40190843
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    APLASIA CUTIS CONGENITA TYPE I - A CASE SERIES.

    Wollina U, Chokoeva A, Verma S, et al.

    Georgian medical news 2017; 7-11.

    PMID: 28480840
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    Aplasia Cutis Congenita: A Case Report.

    Ugowe OJ, Balogun SA, Adejuyigbe EA

    West African journal of medicine 2021; (38(4)):391-394.

    PMID: 33904163
  9. 9

    Multidisciplinary management of a previously unreported presentation of severe aplasia cutis congenita.

    Davis MJ, Voller LM, Gonzalez SR, et al.

    Pediatric dermatology 2021; (38(2)):472-476 doi:10.1111/pde.14528.

    PMID: 33481290
  10. 10

    [Aplasia cutis congenita].

    Rogvi Rá, Sommerlund M, Vestergaard ET

    Ugeskrift for laeger 2015; (177(42)):V09140483.

    PMID: 26471170
  11. 11

    A Closer Look at Aplasia Cutis Congenita: Understanding a Unique Case.

    Jumei'an A, Ababneh H, Jaradat M, et al.

    Cureus 2024; (16(6)):e61516 doi:10.7759/cureus.61516.

    PMID: 38957254
  12. 12

    Focal Cortical Dysplasia in an Infant With Aplasia Cutis Congenita: A Case Report.

    Mazeda I, Vivas I, Ramos S

    Cureus 2025; (17(5)):e84842 doi:10.7759/cureus.84842.

    PMID: 40568286
  13. 13

    Aplasia cutis congenita associated with fetus papyraceous.

    Mishra S, Nagar S, Kumar TS

    BMJ case reports 2025; (18(3)) doi:10.1136/bcr-2024-263031.

    PMID: 40132947
  14. 14

    Aplasia cutis congenita of the trunk in a newborn: a rare case report.

    Ahmed EM, Najoua A, Salma F, et al.

    The Pan African medical journal 2024; (48()):52 doi:10.11604/pamj.2024.48.52.43784.

    PMID: 39315062
  15. 15

    Large aplasia cutis congenita of the vertex conservative management.

    Bouali S, Charfeddine SH, Ghedira K, et al.

    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery 2024; (40(2)):285-292 doi:10.1007/s00381-023-06190-x.

    PMID: 37865964
  16. 16

    Amniotic membrane dressings for treatment of aplasia cutis in newborns.

    Kadivar M, Sangsari R, Rostamli S, et al.

    Pediatric dermatology 2024; (41(3)):445-450 doi:10.1111/pde.15540.

    PMID: 38409959
  17. 17

    Aplasia cutis congenita of both knees: A new therapeutic strategy.

    Charvillat O, Plancq MC, Haraux E, et al.

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    PMID: 32417075
  18. 18

    A rare case of aplasia cutis congenita.

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    Asian journal of surgery 2023; (46(11)):4848-4849 doi:10.1016/j.asjsur.2023.05.131.

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  19. 19

    Aplasia cutis congenita of the scalp: Histopathologic features and clinicopathologic correlation in a case series.

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    PMID: 31904134

This page provides educational information about Aplasia Cutis Congenita. It does not replace professional medical advice, diagnosis, or treatment from your child's pediatrician or pediatric dermatologist.

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