- Can occur in infants and during puberty.
- Most babies do not need any treatment. It gets better over 6 months time.
- If any s/o infections or suspicion in a baby, do a swab for culture/ sensitivity and start oral flucloxacillin ( or clarithromycin if allergic) for a week
- Early treatment helps control acne symptoms and scarring
- The therapy needs to be continued till disease process stops
- Initial control of disease may take up to 8 weeks after continued treatment.
- If a parent notices any particular food making acne worse, advise to avoid.
- Cleansing with any mild soap and water may help by removing the oil from skin ( up to 2 times a day)
- Repetitive cleaning may cause excessive drying of skin
- Avoid oily or greasy face and hair creams as it worsens acne
- Avoid squeezing the acne as it worsens the inflammation
MANY OF THE BELOW MEDICATIONS HAVE DELETERIOUS EFFECTS DURING PREGNANCY. MAKE SURE THE TEENAGER IS NOT PREGNANT.
TOPICAL TREATMENTS (Retinoids and antibacterial applications)
- use at least 8 weeks before changing
a) Retinoids ointments
- First line of treatment
- Start every alternate day and increase the dose as tolerated
example for retinoid ointments-
- Tretinoin- 0.05 to 0.1% ointments . to apply once at night
- Adapalene- 0.01% cream to apply at night
b) Antibacterial ointments
Benzoyl peroxide with zinc-
- Use twice daily
- Lotions and body wash can be used in acne over chest/ back
Clindamycin/ erythromycin ointment–
- Use twice daily
- Used in severe cases or in the failure of topical management after 6-8 weeks
- Oral antibiotics should be given with local retinoid treatment always
- Use for 8 weeks at least and tape the dose
Tetracycline – ( in 12-17 years,: 500 mg twice daily for 3 months at least, up to 2 years)
Doxycycline – ( in children 12-17 years: 100 mg once daily)
Erythromycin – ( child age 1 month to 2 years- 250 mg once daily/ in children 12- 17 years: 500 mg twice daily)
- 0.5 to 1 mg/kg/day in divided doses
- The treatment goes on for 5 months
- AVOID IN PREGNANCY
In the failure of above measure, refer to a dermatologist.