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Acne Neonatorum

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Acne Neonatorum, Neonatal Acne, Acne in the Newborn

  • See Also
  1. Newborn Skin Exam
  • Epidemiology
  1. Onset in up to 20% of newborns
  • Pathophysiology
  1. Maternal androgenic Hormones stimulate the newborns Sebaceous Glands
  2. Resolves without scarring when maternal Hormones wane after 3-4 months
  • Signs
  1. Characteristics
    1. Comedones (typically closed comedones)
    2. Inflammatory Papules, Pustules and Nodules may occur
  2. Distribution: Face
    1. T-Zone: Forehead, nose, cheeks and chin
  3. Timing
    1. Onset in the first 4 weeks of life (not present at birth)
  • Differential Diagnosis
  1. Neonatal Pustules and Vessicles
  2. Infantile Acne
    1. Onset at >6 weeks of life and persists for 6 to 12 months
    2. More inflammatory than Neonatal Acne
  3. Hyperandrogenism (e.g. adrenal cortical hyperplasia)
    1. Consider in severe, refractory and persistent cases
  • Management
  1. Resolves spontaneously without treatment
  2. Treatment can be used if parents wish
    1. Over the counter acne soaps (low pH)
    2. Sparing use of Benzoyl Peroxide lotion 2.5% (test first on antecubital fossa)
  • References
  1. Claudius and Behar in Herbert (2020) EM:Rap 20(8): 5-7
  2. Katsambas (1999) Int J Dermatol 38:128-30 [PubMed]
  3. O'Connor (2008) Am Fam Physician 77:47-52 [PubMed]
  4. Snyder (2024) Am Fam Physician 109(3): 212-6 [PubMed]