From the Guidelines
Neonatal acne typically requires no treatment as it resolves spontaneously within a few weeks to months. Parents should gently cleanse the baby's face with water and mild soap, avoiding harsh scrubbing or adult acne products. If the acne is severe or persistent, a pediatrician may recommend a mild topical treatment such as 2.5% benzoyl peroxide cream applied sparingly once daily, or in rare cases, a low-strength topical retinoid or 1-2% ketoconazole cream 1. These medications should only be used under medical supervision. Parents should avoid applying oils, lotions, or creams to affected areas as these can worsen the condition by clogging pores. Neonatal acne occurs due to maternal hormones that cross the placenta during pregnancy, stimulating the baby's sebaceous glands. These hormones typically clear from the baby's system within a few months, which is why the condition is self-limiting. If the acne worsens, spreads, or is accompanied by other symptoms, medical evaluation is necessary to rule out other conditions.
Some key considerations for treating neonatal acne include:
- Gentle skin care to avoid irritating the skin
- Avoiding the use of adult acne products, which can be too harsh for a newborn's skin
- Considering mild topical treatments under medical supervision for severe or persistent cases
- Monitoring for any signs of worsening or complications, such as infection or scarring
It's essential to note that the guidelines for treating acne vulgaris, as outlined in studies such as 1 and 1, may not directly apply to neonatal acne, as the condition is self-limiting and typically resolves on its own. However, these guidelines can provide valuable insights into the management of acne in general, and the importance of gentle skin care and avoiding harsh products.
In terms of specific treatments, topical benzoyl peroxide or retinoids may be considered for mild to moderate acne 1, but these should only be used under medical supervision in newborns. The use of oral antibiotics or isotretinoin is generally not recommended for neonatal acne, as the condition is typically mild and self-limiting 1.
Overall, the key to managing neonatal acne is to prioritize gentle skin care, avoid harsh products, and seek medical evaluation if the condition worsens or persists.
From the Research
Treatment for Neonatal Acne
The treatment for neonatal acne is primarily focused on gentle skin care and, in some cases, the use of topical treatments. Key points to consider include:
- The use of mild dermal cleansers and water is often sufficient for managing neonatal acne 2.
- For comedogenic lesions, such as open and closed comedones, topical retinoids or 20% azelaic acid may be used 2.
- Topical antibiotics can be considered for inflammatory lesions 2.
- It is essential to avoid harsh products and focus on maintaining the skin's natural barrier, which can be achieved with the use of ceramide-containing moisturizers 3.
- Skincare for neonates should be safe, effective, fragrance-free, and free of sensitizing agents 3.
Skincare Principles for Newborns
General skincare principles for newborns that can help in managing neonatal acne include:
- Gentle cleansing, with an emphasis on using mild products infrequently, especially in the newborn period 4.
- Adequate hydration and moisturization of the skin, although the use of emollients should be limited in warm weather 4.
- Preventing friction and maceration in body folds 4.
- Protection from irritants and bright sunlight 4.
- Bathing immersed in water or washing with synthetic detergents (syndets) or mild liquid baby cleansers seems comparable with or even superior to water alone 5.
Evidence-Based Recommendations
Evidence-based recommendations for the diagnosis and treatment of pediatric acne, including neonatal acne, suggest a tailored approach based on the age and pubertal status of the child 6. These recommendations include the use of over-the-counter products, topical benzoyl peroxide, topical retinoids, topical antibiotics, oral antibiotics, hormonal therapy, and isotretinoin, with specific considerations for neonatal acne 6.