Infantile Acne

Dr. Greene, my son is now 17 months and still has a whitehead on his cheek, and he also has blackheads. If he got them from breast-feeding I sure won’t breast-feed the next one. I would really like his skin to clear up already, and the whitehead on his face is raised and very obvious. I have even tried to use pore strips to remove them. I am desperate and depressed to see my poor baby’s skin so teen-aged already. Help!!!!!!!!
Worried and Concerned Parent

Infantile Acne

Dr. Greene’s Answer:

Toddlers often have the cutest little faces! How frustrating when acne gets in the way. When most people think of acne, they think of the pimples that affect about 80% of teens as they go through puberty. But acne can occur at any time in life when hormones are in flux. Think mid-life, for instance, when 6% of men and 8% of women in their 50s have acne (British Medical Journal, 1979;1:1109–1110).

New parents often learn about an early round of acne– newborn acne or neonatal acne –that comes and goes during the first weeks or months of life. Newborn acne is usually quite mild. Because newborn acne is very common, when people see pimples on a baby, they usually reassure the parents that they will disappear soon on their own.

But for a few kids, this is not true.

There is another variety called infantile acne that often lasts 2 or 3 years unless properly treated. It has even been reported to last as long as 11 years (Clinical Pediatric Dermatology, WB Saunders, 1993). It is more common in boys than in girls. These kids have skin that is particularly sensitive to the male hormones that are often at relatively high levels in the early years (Dermatology, 1998;196:95–97).

Sometimes infantile acne is so mild that daily, gentle cleansing with a mild soap and water is all that is needed. But it’s not unusual for infantile acne to be more serious (Pediatric Dermatology, 1997;14:17–21). If gentle cleansing doesn’t do the job, a mild topical agent (such as a prescription form of benzoyl peroxide for infants or a topical antibiotic) can often help both the current situation and prevents scarring. If the problem persists, see a pediatric dermatologist for stronger treatment. There are enough good options available that your toddler shouldn’t have to live with prominent pimples on his face.

If a pediatric dermatologist can’t get it under control or if there are any other signs of puberty (e.g. deep voice, pubic or underarm hair), then someone should investigate for conditions that cause abnormally high levels of puberty hormones.

Nursing, by itself, doesn’t cause acne. But drugs can trigger it, whether taken by the baby or by a nursing mom. The most common culprits are steroids (either oral or topical), antidepressant medicines, antiseizure medicines, lithium, iodides, bromides, and antituberculosis drugs. Oral contraceptives do pass through into breast milk and are steroids that can occasionally cause acne and breast enlargement in the breast-feeding children.

When teens look in the mirror, their pimples often look gigantic even when friends barely notice them. Being a parent can affect our perceptions as well. Sometimes we don’t notice our children’s blemishes, even when they are obvious to others; sometimes our kids’ blemishes are glaring to us and not noticed by others.

Whatever the case, you and your darling son needn’t “just wait until they go away.” You both deserve for these to be treated effectively.

My oldest son is just now going through puberty. What a wonderful, bittersweet time! Your son’s bout with “teenage skin” is a good reminder to us all that childhood rushes by in slow motion–the stages seem long, but…

Dr. Alan Greene

Dr. Greene is the founder of (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.

  1. Lara

    Hi Dr Greene

    My son is now 8 years old. He has had acne ever since he was born! When I first raised the issue of his skin not long after he was born, the doctors all dismissed it as infantile acne which would go by the time he was 12months old. At 18 months he obviously still had it and I requested a referral to a dermatologist who merely confirmed that it was indeed acne and prescribed topical treatments … all of which did absolutely nothing! Thereafter I tried to do more research and requested referral to a paediatric endocrinologist. Again, despite a small anomaly in his bone age (at that time – 1yr more advanced than his chronological age), all results came back pretty normal – nothing alarming in his hormone levels; no sign of hair growth etc.

    Subsequent to that we also tried the alternative therapies route – whereupon a homeopath/reflexologist did say to us that it appeared he may have a gluten sensitivity. We therefore started following a gluten-free diet which certainly did seem to have a considerable degree of success. Unfortunately, in the last few months, the acne has made a significant ‘comeback’ no matter how strictly he follows the diet, and we are once again back to having to look at his hormone levels etc.

    I am also waiting on a referral to a paediatric dermatologist again, but we are at our wits end with how we can best help him and try and help clear his skin. He is obviously at an age where it is starting to cause him concern (and we are often reduced to tears ourselves although we try not to let him know), and with so many years still ahead of him even as a teenager having to deal with acne, if we could even have some way or idea of what may be causing this and how we can deal/ treat it, it would be the answer to all our prayers.

    Please, please, please could you advise us or point us in the right direction – any research I’ve managed to do, or when I’ve asked the general doctors, all they can come up with now is premature puberty (which I sincerely don’t believe it is as he has had this his WHOLE life so far and shows no other indications/ symptoms of)! Many thanks

    • Caroline

      Have you ever tried eliminating cows milk from his diet? Our15 month started getting spots on his face after we slowly introduced cows milk at 11 months. We just made the connection and just stopped the dairy products. After doing some research I read that hormones found in ALL milk can cause acne.

    • Dee

      Have you ever found anything to treat your sons skin? My baby is 16 month and has had sever acne since he was 2 weeks old. I was told from the beginning it would go away on its own. I’m now seeing a dermatologist who has tried 4 separate treatments including different antibiotics and cream which have had no effect what so ever. I feel like this is never going to go away and the longer time is going on, the more scars he is going to have. He has had blood tests that have came back normal. Any advice would be so helpful.

  2. Tom Schneeberg

    My 26 month old son has a rash of whiteheads on the underside of his chin. He hasn’t used a pacifier in over a year and isn’t drooling from teething. We originally thought that it was an allergic reaction from rubbing on the collar of his winter coat but now we haven’t used it as frequently and they are still there. We asked his pediatrician at his 2 year check up and he wasn’t concerned. I just don’t want this to turn into something that spreads or creates scars. They seem to flare and open up then go away but within a few weeks they’re back. They don’t seem to itch or bother him. Any suggestions would be helpful?


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