What are the recommendations for treating adolescent, preadolescent, infant, and neonatal acne vulgaris?

Updated: Mar 26, 2019
  • Author: Jaggi Rao, MD, FRCPC; Chief Editor: William D James, MD  more...
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The American Academy of Pediatrics has endorsed the recommendations of the American Acne and Rosacea Society for the diagnosis and treatment of pediatric acne. [25] The evidence-based guidelines used age and pubertal status to delineate classification, diagnosis, evaluation, and management, as well as special concerns such as the psychosocial effects of acne, treatment adherence, and dietary considerations.

The following are among recommendations presented for adolescent, preadolescent, infant, and neonatal acne [25] :

  • Benzoyl peroxide is generally safe and effective as monotherapy or when used in topical combination products for mild acne (level A)

  • Topical retinoids may be used either as monotherapy or in combination with other products and in therapeutic regimens for all types and severities of acne in children and adolescents of all ages (level A)

  • Oral antibiotics may be used for moderate-to-severe inflammatory acne for any age (except for tetracycline in children <8 years) (level B)

  • Hormonal therapy with combination oral contraceptives may be used as second-line therapy in pubertal females with moderate-to-severe acne (level A)

  • Isotretinoin is recommended for severe, scarring, and/or refractory acne in adolescents (level A)

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