II. Epidemiology

  1. Onset in up to 20% of newborns

III. Pathophysiology

  1. Maternal androgenic Hormones stimulate the newborns Sebaceous Glands
  2. Resolves without scarring when maternal Hormones wane after 3-4 months

IV. 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)

V. 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

VI. 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)

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