Treatment
Neonatal acne will typically resolve by itself in 2-6 months. In mild cases, cleansing the face daily with gentle soap and water while avoiding use of potential comedogenic soaps, lotions and oils is often enough. Further treatment is not necessary but in severe or persistent cases topical therapy can be initiated. Benzoyl Peroxide
Topical benzoyl peroxide (BPO) may be indicated in persistent or inflammatory cases. BPO is a lipophilic agent that penetrates into sebaceous glands and generates reactive oxygen species that kill P. acnes. It also has comedolytic and anti-inflammatory properties and can prevent development of antimicrobial resistance. Topical Retinoids
Topical retinoids can be used alone or in combination with BPO. Retinoids are derived from vitamin A. They bind to retinoic receptors to normalize the rate of keratinocyte growth and prevent inflammation. Overactive keratinocyte production can lead to comedone formation. Topical Antibiotics
In cases where scarring is a concern, topical antibiotics may be recommended. Topical clindamycin and erythromycin are the most commonly prescribed options for acne. Antibiotics kill P. acnes on skin that could be causing inflammation. With the emergence of resistant P. acnes, experts recommend topical antibiotics to be used in combination with BPO to reduce the risk of development of antimicrobial resistance. The most common side effects of topical antibiotics are stinging, burning and redness at the site of application. Topical antifungals
Some experts suggest the use of topical ketoconazole in newborns with more pustular neonatal acne as there is evidence it shortens duration of lesions.
Neonatal acne, also known as acne neonatorum, is an acneiform eruption that occurs in newborns or infants within the first 4-6 weeks of life, and presents with open and closed comedones on the cheeks, chin and forehead.The main cause is not known for certain but it may be caused by maternal androgens transferred from the mother to the newborn from the placenta and androgens produced by the fetal adrenal gland and neonatal testicles that stimulate sebaceous glands to increase production of sebum. As a self-limiting condition, neonatal acne tends to resolve on its own but treatment options can include topical benzoyl peroxide, topical retinoids, topical antibiotics and topical antifungals. Signs and Symptoms
Neonatal acne presents from birth to within the first 4-6 weeks of life. Common symptoms are open and closed comedones such as papules and pustules that occur most commonly on the face on the areas of the cheeks, chin and forehead. Less commonly, lesions can be present on the chest and back. Causes
It is believed that maternal androgens passed to the infant through the placenta has a role in stimulating sebaceous glands leading to increased sebum production that causes comedone formation.