What are the other Names for this Condition? (Also known as/Synonyms)

• Acne in Infants
• Baby Acne

What is Infantile Acne? (Definition/Background Information)

• Acne is a common skin condition in which inflamed red spots or lesions appear on the face, neck, shoulders, and other regions. It is mostly observed during adolescence. Infantile Acne occurs as a mild to moderately severe condition in children under 12 months of age
• The condition presents as numerous tiny red skin lesions, usually on the face (cheeks) and neck region, commonly in boys. It also can include whiteheads and blackheads (closed and open comedones). Infantile Acne is different from neonatal acne, seen in the first month of life
• Infantile Acne is mostly a temporary condition that resolves by its own even without treatment in a few months. Occasionally, the condition may be severe and result in scarring, or return with greater severity during puberty

Who gets Infantile Acne? (Age and Sex Distribution)

• Infantile Acne is described in babies between 6 weeks to up to 12 months old
• The skin condition affects boys more than girls
• There is no racial or ethnic predilection, and Infantile Acne is observed worldwide
• It is reported that about 1 in 5 infant children may develop this condition

What are the Risk Factors for Infantile Acne? (Predisposing Factors)

There are no well-defined risk factors for Infantile Acne. However, if hormonal factors are noted, then the acne may be observed in the context of the following conditions:

• 21-hydroxylase deficiency disorder
• Androgen-secreting tumors
• Congenital adrenal hyperplasia (CAH)
• Cushing syndrome
• Use of certain medications
• Early onset of puberty

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Infantile Acne? (Etiology)

The cause of Infantile Acne is not well understood. Some researchers believe that it may develop from genetic and environmental factors. In some cases, the condition is associated with hormonal abnormalities. However, the children are generally noted to be healthy.

• The roots of the hair (called follicles) are attached to sebaceous glands. These glands secrete oil (sebum) to lubricate the hair shaft and skin surface skin around it. When excess oil mixes with dead skin cells to plug the hair follicles, it leads to the formation of acne
• The blocked hair follicles appear as a surface lump (white, black or red, inflamed) or a bulge, in which bacteria thrive. If these are below the skin surface, they are termed as boils or cysts

What are the Signs and Symptoms of Infantile Acne?

The signs and symptoms of Infantile Acne are as follows:

• The cheeks usually present the acne pimples. These can be noted on the chin and forehead too
• Other parts of the body, such as the neck and upper trunk (chest and back), may also be involved
• The acne skin lesions are generally red, tiny, and numerous
• It may be in the form of papules, nodules, and blisters
• Comedones (whiteheads and blackheads) may be noted
• The condition may be aggravated by saliva/vomit on face or on using rough fabrics
• Infantile Acne are mostly non-itchy and not painful
• These acne lesions may result in scarring

The condition may be mild or moderate in severity.

How is Infantile Acne Diagnosed?

• Infantile Acne is frequently diagnosed through a simple physical examination by the pediatrician or dermatologist. Visualization is usually sufficient unless it is in older children between 2 and 6 years
• Other medical investigations may be necessary only if the healthcare provider suspects that hormonal or other factors are involved
• A hormone evaluation should be done if other signs of increased androgens are present. This would include extra hair growth (hirsutism), certain changes in the genitalia, and rapid growth as indicated on the growth chart

A differential diagnosis may be necessary to eliminate other conditions that present similar signs and symptoms such as:

• Eczema
• Erythema toxicum
• Milia

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Infantile Acne?

Some of the complications of Infantile Acne may include:

• Emotional and psychological stress for the parents
• Rarely, it can result in permanent scarring (pit-like scars may be noted)
• If Infantile Acne is severe in infancy, then acne that develops during puberty/adolescence may be severe (recurrence may be severe)
• Side effects of local/topical applications

How is Infantile Acne Treated?

Treatment is mostly not needed for Infantile Acne; however, the healthcare provider may consider treatment for severe cases. These may include:

• Use of topical applications and creams such as benzoyl peroxide or erythromycin gel
• Oral medications, if Infantile Acne is even severe, such as erythromycin and trimethoprim, or isotretinoin, may be prescribed
• Treatment of the associated condition, if any present, may have to be undertaken

Note:

• Tetracycline is not used in young children as it can cause staining of permanent teeth
• Avoid any OTC agents (creams/lotions) for acne in children, as the condition may get worse

How can Infantile Acne be Prevented?

Currently, there are no available guidelines or measures to prevent Infantile Acne. However, the following measures may be considered by parents/caregivers to reduce its severity and/or prevent aggravation of the same:

• Regular washing baby’s face and body with mild baby soap
• Avoiding perfumed baby products such as soaps or bubble baths
• Avoiding scrubbing baby’s body and face
• Not pinching or squeezing the acne pimples

What is the Prognosis of Infantile Acne? (Outcomes/Resolutions)

• In most cases, Infantile Acne reduces in intensity and resolves in a few months (mostly) to a year, usually by age 2, without treatment
• In some babies with severe acne, after the condition resolves, it may return during puberty with even greater severity

Additional and Relevant Useful Information for Infantile Acne:

• Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition
• The presence of dirt on the body is not a causative factor for acne; but, it helps to be clean and hygienic