Childhood acne

What is childhood acne?

True childhood acne generally affects the cheeks, and sometimes the forehead and chin, of children ages six weeks to one year. It is more common in children and is generally mild to moderate in severity. In most children it sets in a few months.

Acne may include comedones (pimples and blackheads), inflamed papules and pustules, nodulesand cysts Can cause scarring.

See more images of acne in young children.

What is the cause of childhood acne?

The cause of childhood acne is unknown. It is believed to be genetic in origin. Usually not due to excess testosterone or other androgenic hormones, and children with childhood acne often look quite normal.

Acne is rare in prepubertal children older than 2 to 6 years. It is associated with higher levels of androgens than expected for the child's age. These can result in virilization. The signs of virilization are:

• Excessive body hair
• Abnormal growth
• Genital and breast development
• Body odor.

Hormonal abnormalities in children with acne may be associated with the following conditions:

• Congenital adrenal hyperplasia
• Cushing syndrome
• 21-hydroxylase deficiency
• Early puberty
• Androgynous-secretory tumors
• Medicines
• Premature adrenache (early puberty).

Should I have a test?

In most babies with acne, research is not needed. In older children, or if there are other signs of virilization, the following screening tests may be helpful.

• Blood tests: DHEAS, testosterone, 17-hydroxyprogesterone, LH, FSH, prolactin
• X-ray: measurement of bone age

What is the result of childhood acne?

Severe childhood acne can cause permanent scarring. People with severe childhood acne tend to develop troublesome acne at puberty.

What is the treatment for childhood acne?

Childhood acne treatment is usually with current agents like benzoyl peroxide or erythromycin gel.

In severe cases, oral antibiotics such as erythromycin and trimethoprim or isotretinoin may be required.

NOTE: Tetracycline antibiotics should not be used in young children because they can cause yellow spots on permanent developing teeth.