What is the treatment for baby acne?

Treatment for Baby Acne

Baby acne (neonatal acne) is typically self-limiting and requires minimal intervention. Most cases resolve spontaneously with gentle cleansing using mild soap and water. 1

Types of Baby Acne

• Neonatal acne: Appears between the second and fourth weeks of life in approximately 20% of newborns, more common in males (4.5:1 ratio) 1
• Infantile acne: Occurs between 3-16 months of age, tends to be more inflammatory and pleomorphic than neonatal acne 2

First-Line Treatment

• Gentle cleansing: Use mild soap and water to clean affected areas once or twice daily 1
• Avoid harsh products: Do not use medicated soaps, abrasive cleansers, or alcohol-containing products that can irritate the baby's sensitive skin 3
• No treatment: Most cases of neonatal acne resolve spontaneously without intervention within weeks to months 1

When to Consider Medical Treatment

For persistent or severe cases that don't respond to gentle cleansing:

• Topical treatments: Consider only when baby acne is severe or persistent 4
  • Benzoyl peroxide (2.5%): Can be used in low concentrations for inflammatory lesions, but use with caution due to potential irritation 5
  • Azelaic acid (20%): May be used for comedogenic lesions and has a favorable safety profile (pregnancy category B) 5, 1

Treatment Considerations by Age

• Neonatal acne (0-6 weeks):

  • Primarily observation and gentle cleansing 1
  • Typically resolves spontaneously without scarring 2

• Infantile acne (3-16 months):

  • May require more active treatment due to increased inflammation 2
  • Topical agents may be considered for persistent cases 4

Important Precautions

• Avoid adult acne medications: Many topical medications have not been established as safe in children under 12 years 5
• Avoid tetracyclines: Contraindicated in children under 8 years of age 6
• Avoid oral isotretinoin: Not recommended in children under 12 years according to FDA 6
• Monitor for irritation: If using any topical treatment, watch for signs of excessive dryness, redness, or irritation 3

When to Consult a Pediatrician or Dermatologist

• Severe or persistent acne: Especially if associated with scarring 7
• Early onset or severe infantile acne: May be associated with hormonal abnormalities and could predict more severe adolescent acne 2, 6
• Signs of infection: Increasing redness, warmth, pain, or pus 4
• Unusual distribution: Acne in atypical locations beyond face, neck, and upper chest/back 1

Key Points to Remember

• Patience is key: Most baby acne resolves on its own without treatment 1
• Avoid picking or squeezing: This can cause infection or scarring 4
• Minimize irritation: Keep the affected areas clean but avoid excessive washing or scrubbing 3
• Document progression: Taking photos can help track whether the condition is improving or worsening 7