Acne is a disease that can be seen in the first year of age, early childhood, prepubertal age and puberty. Neonatal acne or baby acne is due mainly to considerable sebum excretion rate. Hereditary factors play an important role in acne. Neonatal acne has proven genetic influences.
Neonatal acne is present at birth or appears shortly after. It is more common than fully appreciated; if the diagnosis is based in a few comedones more than 20% ofnewborns are affected. The most common lesions are comedones, papules and pustules. They are few in number and usually localized on the face, more often cheeks and forehead.
Involvement of the chest, back or groins has been reported. Most cases are mild and transient. Parents wondering how long does baby acne last should be reassured. Lesions appear mainly at 2–4 weeks healing spontaneously, with- out scarring, in 4 weeks to 3–6 months. Neonatal acne has been suggested to be more frequent in male infants.
What does baby acne look like? An example of it can be seen in the picture on the top left. This is a mild case of baby acne and an example of severe baby acne can be seen below it.
So what causes baby acne? The pathogenetic mechanisms of neonatal acne are still unclear. A positive family history of acne supports the importance of genetic factors. Familial hyperandrogenism including acne and hirsutism give the evidence that maternal androgens may play a role through transplacental stimulation of sebaceous glands.
There is a considerable sebum excretion rate during the neonatal period which decreases markedly to almost not detectable levels following the significant reduction of sebaceous gland volume up to the age of 6 months.
There is a direct correlation between high maternal and neonatal sebum excretion suggesting the importance of maternal environment on the infant sebaceous glands. Neonatal adrenal glands produce a certain amount of ß-hydroxysteroids that prepare the sebaceous glands to be more sensitive to hormones in the future life.
In males from 6 to 12 months there are increasing levels of luteinizing hormone (LH) and as a consequence of testosterone; these androgens plus those of testicular origin partially explain the male predominance of neonatal and infantile acne.
The differential diagnosis include milia, miliaria, sebaceous gland hyperplasia, bilateral naevus comedonicus, acneiform eruptions due to the use of topicals, oils and ointments, to maternal medications (lithium, hydantoin, steroids), or due to virilizing luteoma in pregnancy.
Deficiency of the 21-hydroxylase and adrenal cortical hyperplasia should also be considered. Neonatal acne can also be confused with cephalic pustulosis due to malassezia species (mainly Malassezia sympodialis). Clinically the lesions are very similar to acne and are a consequence of an overgrowth of these lipophilic yeasts (on a neonate with high sebum production) that leads to an inflammatory reaction and poral or follicular occlusion.
How to Treat Baby Acne – Baby Acne Remedies
Treating baby acne is often a main concern of parents and many of them are anxious in finding the right treatment for baby acne. Learning what to do for baby acne involves consulting your doctor or a dermatologist. Be careful with using over-the-counter products which may be too harsh for the baby’s skin.
The usual baby acne treatment are usually topical: they simply involve the use of specialized acne creams. Baby acne has shown a positive response to 2% of ketoconazole cream. Topical treatments for comedones include retinoids such as tretinoin (cream 0.025–0.05%) or azelaic acid (cream 20%) daily or in alternating days. For inflammatory lesions, topical antibiotics (erythromycin 4% pads, pledgets, cream, gel) and benzoyl peroxide (wash, gel 2.5%) are useful.
All in all, neonatal acne or baby acne isn’t a serious problem and parents can take comfort in the fact that it is a transient problem. Neonatal acne will fade away with time and there usually will not be any noticeable baby acne scars.
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