Harlequin Color Change

What’s the harlequin color change?

Harlequin Color Change

Dr. Greene’s Answer:

Babies’ blood vessels start off highly reactive and unstable. A mild change in temperature or position or mood can cause swift changes in the diameters of the blood vessels, with resultant color changes of the overlying skin. The most extraordinary example of this is the harlequin effect.

A sharp line from the forehead to the pubis divides the body into 2 vertical halves. One side turns dark red, the other quite pale. The overall effect is reminiscent of the bold patches of color on a harlequin costume.

This rare but dramatic event only occurs in the immediate newborn period. It usually begins when the baby is positioned on her side. The upper half of the body becomes pale, and the lower half deep red. Changing her position can reverse the pattern. If she moves a lot, the muscle activity will erase the color changes (rather like shaking an Etch-a-sketch toy).

The harlequin color change is most common in low birthweight infants, but can occur in any child. Babies who experience this once will often take on the harlequin pattern multiple times.

Still, the condition is as temporary as being a newborn. The harlequin color change is entirely harmless. It has never been associated with any permanent problem.

Dr. Alan Greene

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

  1. Elyse Silver

    The condition isn’t always ‘temporary’ my son had this as a baby – he’s now 10 years old and still gets this when he gets hot, is ill or does any sort of keep fit.


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