Infantile acne

True infantile acne generally affects the cheeks, and sometimes the forehead and chin, of children aged one to six years. It is more common in boys and is usually mild to moderate in severity. In most children it settles down within a few months.

The acne may include comedones (whiteheads and blackheads) and inflamed papules and pustules. It may result in scarring.

Neonatal cephalic pustulosis

Neonatal cephalic pustulosis is sometimes called ‘neonatal acne’. It is a pustular eruption arising on the face and/or scalp of newborn babies often during the third week. There are no comedones.

Acne in babies

Infantile acne

Neonatal cephalic pustulosis

What is the cause of infantile acne?

The cause of infantile acne is unknown. It has been thought to be hormonal in origin, particularly adrenal androgens such as dehydroepiandrosterone but occasionally excessive testosterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH) have been found. However, in most babies with acne, no investigations are necessary.

What is the cause of neonatal cephalic pustulosis?

Some researchers believe that neonatal cephalic pustulosis is related to malassezia colonisation, which may be found on mycology (microscopy and culture). The role of the yeast is unclear.

What is the result of infantile acne?

Severe infantile acne may result in permanent scarring. Individuals with severe infantile acne tend to develop troublesome acne at puberty.

Scarring from infantile acne

What is the result of neonatal cephalic pustulosis?

Neonatal cephalic pustulosis does not cause scarring. It settles within a few weeks of onset.

Treatment

Treatment of infantile acne is usually with topical agents such as 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 used in young children because they may cause yellow staining of the developing permanent teeth.

Neonatal cephalic pustulosis generally resolves without treatment. However, if the appearance is unsightly, a topical antifungal cream can be used safely and may be helpful.