Pediatric acne: Clinical presentations, evaluation, and management.

Abstract

Acne vulgaris can be easy to diagnose yet difficult to evaluate and manage, especially when it presents in infancy and childhood. The differential diagnosis of acne varies by age and, in some cases, may warrant a work-up in order to rule out underlying systemic abnormalities. Likewise, treatment strategies can be influenced by the patient's age. In this article, we present an overview of the clinical presentations of acne by age, an approach to patient evaluation, and a general strategy for management of this common and important disease.

Introduction

While part of its name, vulgaris, reflects the very fact that it is common, acne vulgaris is much less common in babies, toddlers, or preadolescents. In most individuals at a variety of ages acne vulgaris is not subtle, and a preteen or teen presenting with comedones, pustules, and inflammatory papules on his or her face is considered to have acne until proven otherwise. There is a good understanding of the basic pathophysiology of acne, and multiple algorithms have been developed to assist practitioners in composing successful treatment regimens. The pharmaceutical, cosmetics, and cosmeceutical industries have recognized acne as an important consumer concern, supporting the development of a myriad of treatment products from which to choose a therapeutic strategy for individual patients.

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