Whilst more prevalent in teenagers and young adults, acne vulgaris (more commonly known as acne) can affect neonates (new-born to four weeks), infants and young children. However, unlike in adolescence, acne in these childhood groups can mimic other skin eruptions. It is therefore important for children to receive a medical evaluation before the commencement of any treatment.

Paediatric acne is typically divided into the areas of neonatal, infantile, mid childhood, preadolescent and adolescent.

For purposes of this article, Dr Mathobela, a leading specialist dermatologist and OXY’s resident skincare expert, shares some insight and potential treatment options for acne occurring in the mid childhood, preadolescent and adolescent age groups.

Mid Childhood Acne
Falling between the years of one and seven, acne is very rare in this age group. However, should it be suspected, children should be evaluated for hyperandrogenism (excessive androgen production). Children in this age group will typically present with comedones (skin-coloured, small bumps) on the central part of the face or mid face (chin, nose area and forehead).

Potential treatment options could include mild cleansers and moisturisers, with the use of sunscreen very important. Topical treatments are first choice and, often, the same topical agents used for adults can be used for children as well. However, severe cases are often treated with a combination of topical treatments and oral antibiotics (different to those antibiotics used for teenagers and/ or adults).

Prepubertal Acne
This occurs before true puberty, with approximately 61% to 71% of young girls being affected. It usually presents as comedones, with or without papules, pustules and nodules. Lesions are mainly found on the central area of the face (mid forehead, nose and chin). If the acne is severe, children (especially girls) should be evaluated for endocrine disorders.

In this age group, mild cases are treated with topical treatments. In addition, mild cleansers and moisturises, together with sunscreen, should be used. For moderate to severe acne, antibiotics (similar to those used in adults) can be prescribed.

Teenage acne
This age group is the most impacted, with almost as many as 95% of teenagers affected due to the production of androgens (hormones). Other factors thought to exacerbate, or trigger acne, include diet (meat, dairy, high glycaemic index foods) and smoking. While it typically presents as comedonal acne, severe cases can include papules/ pustules and even nodulocystic acne (a severe form of inflammatory acne characterised by the presence of nodular breakouts and cysts). Whilst girls are often more affected than boys, boys usually suffer a more severe form.

The treatment of teenage acne is similar to that of adults. Exfoliating face washes and moisturises can be used for those whose skins are not sensitive. For sensitive skins, mild cleansers and moisturisers are suggested with the use of topical treatments for mild cases. For moderate to severe cases, a combination of oral antibiotics and topical agents is often used with oral isotretinoin considered a safe option for patients experiencing a severe outbreak. In girls, oral contraception can also be considered. Just like in the other age groups, using a non-comedogenic sunscreen is important especially when undergoing treatments with retinoids.