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New Acne Treatment for Kids, How Does It Work?

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2013-05-06 06:48

The vast majority of teenagers experience some degree of acne, but this skin disease can affect younger people as well. That’s one reason why the American Acne and Rosacea Society has issued new recommendations regarding acne treatment for kids, including infants and elementary school aged children, because not all kids should be treated alike.

Do you know how to treat your child’s acne?

Several new studies indicate that acne is not just for teenagers. In fact, according to Lawrence Eichenfield, MD, of Rady’s Children’s Hospital in San Diego, and his colleagues, more than three-quarters of girls ages 9 and 10 had acne in one study, and 20 percent of newborns have the skin disease as well.

In another new study published in FP Essentials, investigators at San Joaquin General Hospital in California report that both neonatal acne and infantile acne (which starts after the neonatal period) typically develops on the face, scalp, back, and chest and usually goes away spontaneously. If either type of acne does not resolve within a year, children should be evaluated for excessive levels of androgens (male hormones).

According to the new guidelines announced by the American Acne and Rosacea Society, which have been endorsed by the American Academy of Pediatrics, each age group requires a different treatment approach. For example:

  • Newborns with acne on the face and upper body should be treated with 2 percent ketoconazole cream. Ketoconazole is associated with side effects that include itching, irritation, dry skin, and stinging. Infants who have significant acne should be checked for tumors, diseases that affect the endocrine system, and sex hormone abnormalities.
  • Infants up to age 12 months can be treated with topical antimicrobials or retinoids, noncycline antibiotics (e.g., erythromycin), and isotretinoin. Use of all these medications is off-label, meaning they are not indicated for this purpose for this age group. Topical retinoids have been approved for children ages 12 and older, while tretinoin gel 0.05% in particular has approval from the Food and Drug Administration (FDA) for children age 10 years and older.
  • Among children up to age seven, acne is usually absent, so if it does appear, it suggests an endocrine problem, which should be checked.
  • In children up to the age of puberty, the development of acne on the face may be the first sign of this change in life. If the acne is severe, clinicians should check for polycystic ovary syndrome (in females) or other endocrine abnormalities.

Children with mild acne may respond to benzoyl peroxide, which the authors of the guidelines noted “has been shown to be the most widely studied of [over-the-counter] products and has been shown to be one of the most versatile, safe, inexpensive and effective acne therapies.” The guidelines are based on an analysis of more than 150 acne-related studies.

Topical benzoyl peroxide should not be used alone, however, and the authors stated that topical antibiotics (e.g., clindamycin, erythromycin) should be added when acne treatment is necessary for more than several weeks. Other treatment recommendations for children included the following:

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