Neonatal and infantile acne


Neonatal and infantile acne

Also known as neonatal acne, neonatal cephalic pustulosis

What‘s the difference between neonatal and infantile acne?

Neonatal acne affects babies in the first 3 months of life. About 20% of healthy newborn babies may develop superficial pustules mostly on the face but also on the neck and upper trunk. There are no comedones (whiteheads or blackheads) present.  Neonatal acne usually resolves without treatment.

Infantile acne is the development of comedones (blackheads and whiteheads) with papules and pustules and occasionally nodules and cysts that may lead to scarring.  It may occur in children from a few months of age and may last till 2 years of age. It is more common in boys.

What causes infantile acne?

Infantile acne is thought to be a result of testosterone temporarily causing an over-activity of the skin’s oil glands. In susceptible children this may stimulate the development of acne.

Most children are however otherwise healthy with no hormonal problem.

The acne reaction usually subsides within 2 years.

What does infantile acne look like?

Infantile acne presents with whiteheads, blackheads, red papules and pustules, nodules and sometimes cysts that may lead to long term scarring. It most commonly affects the cheeks, chin and forehead with less frequent involvement of the body.

How is infantile acne diagnosed?

The diagnosis is made clinically and investigations are not usually required. However, if older children (2 to 6 years) develop acne and other symptoms such as body odour, breast and genital development, then hormonal screening blood tests should be considered.

How is infantile acne treated?

Treatment is usually with topical agents such as benzoyl peroxide, retinoid cream (adapalene) or antibiotic gel (erythromycin).

Oral treatments such as antibiotics (erythromycin), or very occasionally isotretinoin, may be needed if the condition is severe in order to prevent permanent scarring.

What is the likely outcome of infantile acne?

The majority of children require only topical treatments to control the acne and it usually subsides by the age of 2 years.

Children who have been affected by infantile acne may develop problematic adolescent acne.

This information has been written by Dr Li-Chuen Wong
Updated 10 August 2015


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