Infantile Acne

We usually associate the development of acne with adolescence, but acne and acneiform (acne-like) lesions can occur in infants.

A newborn may have an acne eruption on the nose or cheeks. This is usually caused by hormonal changes that occurred as the fetus was developing, and the outbreak typically clears in a matter of weeks, without treatment.

When to See a Physician
A physician should be consulted when:

1. An infant or very young child has acne that persists for more than several weeks. An infant or very young child with acne that persists for more than several weeks should be examined by the child’s pediatrician or a dermatologist. If the acne persists or becomes severe, consultation with an endocrinologist and pediatric dermatologist is recommended. Causes that may be investigated include:

• Family history. Do the infant’s parents, brothers or sisters have acne, or did they have it at some time? A close genetic connection is a high risk factor for developing acne.
• Early hormone production. Does the infant have a condition that causes very early production of sex hormones, especially the androgenic hormones associated with acne? The possibility of sexual precocity (very early sexual development) requires medical attention to prevent or moderate disabilities linked with this condition.
• Growth and developmental abnormalities. Are there any indications of problems with mental or physical development? Very early acne can also be an indication of a developmental abnormality.
• Drug-induced acne or acneiform eruption. Has the infant had any contact with a medication that can cause acne or acneiform lesions, such as corticosteroids or iodine-containing drugs?

2. Acne develops between the ages of 2 and 6. While acne occurs in infants, it usually subsides by age 2. If acne develops between the ages of 2 and 6, a dermatologist should be consulted as this is a stage in life known as the acne free zone.

During the acne free zone, which occurs from approximately 2 to 6 years of age, acne vulgaris rarely occurs. It is believed that acne usually does not occur between the ages of 2 and 6 because sebum production is very low. The low sebum production is probably associated with the low levels of androgenic hormones in the child’s developing body.

	Where Infantile Acne Occurs In infants and very young children, acne usually appears as rash-like comedones and papules on the cheeks and chin. There may also be the occasional small pustules.
	Boys are more likely than girls to have infantile or juvenile acne.
	Photo used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides and the Sulzberger Institute for Dermatologic Education

Treatment
Infantile and juvenile acne is treated in much the same way it is treated in teenagers and adults. Actual treatment usually consists of gently cleansing the skin and treating it with topical agents. Only rarely, in very severe cases, are antibiotics or isotretinoin prescribed. Therapy is required for as long as the acne persists. As in adolescent and adult acne, any underlying condition must also be treated.