Acne infantum is an age-related subtype of the common skin condition acne that affects infants between the ages of three and six months, and should be distinguished from acne neonatorum – a subtype that occurs in newborns younger than three months. Usually, the physician chooses external therapy in the form of mild facial cleansing to treat the skin condition, although antibiotic therapy may also be indicated to regulate inflammatory processes and scarring in more severe forms.
What is acne infantum?
Acne infantum is an age-related subtype of the common skin condition acne that affects infants between the ages of three and six months. Acne is the most common skin condition of all. Viewed over a lifetime, more than 85 percent of all people are affected by it, which in most cases is related to the influence of certain sex hormones. The skin disease is differentiated on the one hand according to severity and on the other hand according to the age of the patient. The term acne infantum is an age-related subtype of the disease. The medical profession understands it as acne in pre-pubertal childhood. This dermatological phenomenon is also called acne infantilis or infantile acne. It is to be distinguished from neonatal acne, the so-called acne neonatorum in babies before the third month of life. Infantile acne, on the other hand, occurs in children between the third and sixth months of life. Boys are more frequently affected by acne infantum than girls, which can be said for acne in general. Particularly severe courses of acne infantum are also called acne conglobata infantum.
Causes
The causes of acne infantum have been poorly understood. It is mainly discussed that there is a temporary high production of androgens, i.e. male sex hormones. In this context, the phenomenon may also be symptomatic of a hormone-producing tumor, which should be clarified in the course of an endocrinological examination. The so-called adrenogenital syndrome can also be accompanied by manifestations of acne infantum, an autosomal recessively inherited metabolic disease that impairs hormone synthesis in the adrenal cortex. However, one of the most common causes of acne infantum, as well as neonatal acne, is congenital hyperplasia of the adrenal glands. This is usually temporary and usually normalizes over a period of six to nine months. Sometimes comedogenic cosmetics can also cause the appearance of acne infantum. If highly oily products are used for the infant’s skin care, dermatological changes often set in. Like any acne disease, acne infantum is probably related to hormonal processes and manifests itself in papules and pustules of the facial and especially cheek skin, although in severe courses deep-seated fistulas and inflammatory nodules also occur, which later leave scars on the skin.
Symptoms, complaints and signs
Acne infantum is a dermatological disease of the facial skin. As a rule, most of the skin changes appear on the cheekbones in particular. These skin changes can be of different forms depending on the severity of the disease. Mostly they manifest themselves as densely standing comedones or in the form of numerous papules and pustules. Apart from this, inflammatory nodules sometimes appear in acne infantum, which are particularly deep and usually melt. Especially the latter manifestations leave permanent scars later, but these can be minimized by appropriate therapy.
Diagnosis and course
The physician usually makes the diagnosis of infantile acne by means of visual diagnosis. The medical history helps him to rule out causes such as the use of comedogenic cosmetics. However, since he must also exclude tumors and phenomena such as the adrenogenital symptom from the differential diagnosis, he usually also orders extensive examinations from the specialist field of endocrinology. In most cases, acne infantum heals completely within a few months with appropriate therapeutic measures and leaves no serious scars. However, in severe courses, healing may take several years, and deep-seated nodules and fistulas in particular may leave facial scars.
When should you see a doctor?
Infant acne is a condition that preferentially affects children between the ages of three and six months.In order to clarify the cause of this skin disease and to find an appropriate treatment, the affected child should be presented to a dermatologist or pediatrician. The latter will refer the child’s mother to an endocrinologist or dermatologist if necessary. The aim here is to minimize the consequences of what is presumably a hormonally induced symptomatology. Acne infantum can lead to severe inflammations on the facial skin of infants. These do not only hurt. They can also be scratched open by the child and lead to fistulas or furuncles of the facial skin. If left untreated, deep scar craters can develop. It would be distressing for the child in every way not to be treated promptly by a physician. In mild courses of acne infantum, observation of the skin may be sufficient. However, since the consequences of another disease may be involved, seeing a doctor is the better choice given the young age of the patient. Whether treatment of the affected skin areas or antibiotic therapy is appropriate should be decided by the attending specialist. The mother should rather not dare to self-treat the infant acne. It could be that acne infantum as a symptom indicates another disease.
Complications
In making a prognosis of infant acne or acne infantum, the course of the disease is significantly involved. However, each of these cases, whether with a mild or severe course, belongs in the care of a physician. In mild cases, the small red pimples with a yellow lump in the center heal completely. The prospects of a complication-free recovery are further increased as soon as a clean cloth is placed under the infant’s cheek during sleep to catch saliva before it touches the skin. Also, never squeeze pimples and pustules. The chances of also developing acne vulgaris during puberty are very high. Common acne is triggered by hormonal changes during puberty and is easily treatable if a doctor is consulted. However, if left untreated, pimples and pustules accompany the young patient until the end of his twenties, in rare cases even until 40 years. What remains are large scarred areas and an often battered self-esteem. In such cases, psychological therapy would be indicated in addition to the medically necessary treatment.
Treatment and therapy
The conventional therapy measure with Acne infantum corresponds to an external therapy, which embraces above all regular and mild skin cleaning. Greasy products must be avoided in this process. Instead, benzoyl peroxide such as acne oxide is applied to the affected skin areas in low concentrations. As an alternative, cream products containing azelaic acid are available, such as Skinoren cream. Since small children have much thinner skin and thus a higher absorption rate than adults or adolescents, the physician must plan the concentrations and application duration of the products as carefully as possible in advance. In more severe forms of acne infantum, systemic antibiotic therapy is used, which is primarily intended to counteract the inflammatory processes and thus prevent scarring. Erythromycin is frequently used in this context and is usually given twice daily.
Outlook and prognosis
In most cases, acne infantum refers to another underlying disease, which is why the treatment of this disease is usually done causally. The affected person suffers from pustules and papules, which may also be associated with pain. However, the symptoms can be eliminated and limited by proper treatment, so there are no particular complications for the patient. Likewise, in severe cases, scars and sores may form and remain until adulthood. As a rule, the treatment is carried out by taking healthy food. Furthermore, the symptoms can be reduced and treated by various care products. If Acne Infantum occurs due to a certain food or ingredient, parents must consider this in their diet to prevent the symptoms and discomfort. Likewise, the patient’s hormonal status can be checked to prevent the same symptoms in adulthood. The life expectancy of the affected person is not limited by the disease and there are usually no further complications.
Prevention
Acne is difficult to prevent. However, good skin hygiene can minimize the risk of disease or at least reduce its severity. Water-based, pH-neutral skin care products in particular can be used in this regard. In addition, a high-glycemic diet should be avoided, as this type of diet is particularly frequently associated with the condition. In some circumstances, it may be useful to have a child’s hormone status determined at an early stage. Homeopathic measures may be available to regulate hormone status.
Follow-up
The options for aftercare are severely limited in most cases of acne infantum. First and foremost, the disease itself must be treated, although aftercare also depends on whether or not the patient’s face has been damaged by Acne Infantum. In most cases the treatment of the disease is carried out with the help of creams, in severe cases with the help of medications. In children, parents should pay attention to regular application of creams to speed up healing. Likewise, other creams or makeup should not be used. Especially greasy skin products should be avoided. The face should be spared and cleansed only with a light lotion. In case of sores caused by Acne Infantum, they can be treated by plastic surgery. However, complete treatment and removal of the wounds is not always possible. It is not uncommon for Acne Infantum to cause depression or other moods, especially in children and adolescents. In this case, discussions with family and friends are useful. Contact with others affected by the disease can also be helpful to exchange information. The patient’s life expectancy is not negatively affected by the disease.
What you can do yourself
Parents can support their child’s healing process in many ways when diagnosed with acne infantum. When it comes to daily skin care, parents should make sure to use mild and non-greasy products. Numerous test seals can make the decision easier when buying care products. Attention should be paid to the designation “skin compatibility confirmed by dermatologists”. Even if skin care products for neurodermatitis sufferers are offered, these products are recommended. Furthermore, the choice of a product of natural cosmetics (ingredients from organic cultivation) can be an option. Depending on the severity of the disease, the doctor may also prescribe medicinal ointments. Parents should pay attention to a gentle dosage, since the child’s skin absorbs the active substances much more strongly. If antibiotic therapy is necessary, the child’s organism can be supported by accompanying treatment with healthy intestinal bacteria. These are available in drop or powder form from pharmacies. Furthermore, parents should pay attention to a comprehensive sun and cold protection. All factors that cause stress to the skin should be minimized. Humidifiers or wet cloths over the radiator can be used to counteract dry room air. If food intolerance is suspected as the cause of skin irritation, parents must take this into account when feeding their child. If an imbalance of the hormonal balance underlies the disease can be treated with homeopathic remedies (Hepar sulfuris, Silicea) supportive.
