While common in adults, acne in toddlers is rare. It is a chronic inflammatory skin disease of sebaceous glands (oil-producing cells). These oil glands are located at the base of hair follicles (1). Extra skin cells and oil may combine to block the hair follicle’s opening, which in turn plugs the oil glands leading to bacterial growth and multiplication, and eventually causing pimples (2). Read on to know more about the causes, symptoms, treatment, and tips to reduce and prevent acne in toddlers.

Is Acne Common In Toddlers?

Acne can occur in toddlers, but it is rare (3). Pediatric acne is divided into five subgroups (4).

Neonatal acne

Infantile acne Mid-childhood acne Preadolescent acne Adolescent acne

Toddler acne falls in the mid-childhood acne category.

Symptoms Of Acne In Toddlers

Mid-childhood acne is usually seen in the age group of one to seven years. The following are the symptoms of acne in toddlers.

Red raised inflammatory papules on the skin surface Painful bumps Lesions mostly on the face, chest, and back Lesions appearing as open or closed comedo, which is commonly known as blackheads or whiteheads, respectively Inflammatory papules and pustules

Causes Of Acne In Toddlers

Acne usually happens due to the circulation of adrenal and gonadal androgen hormones in the blood (3). The secretion of androgens is usually low in children of one to seven years old. However, some substances or conditions might trigger the secretion of androgens. The following are some commonly seen reasons for acne in toddlers.

1. Dairy intake

Dairy intake has been proven to increase the incidence of acne in people between the ages of seven to 30years. It is believed that dairy, especially butter and cheese, intake can cause acne in toddlers, too. However, more research needs to be done to establish the relation of dairy consumption in toddler acne (1).

2. Irritants

Some irritants from soap or cleansers might trigger acne in toddlers with sensitive skin. This is much more common than many other triggers. Some skin lotions can also be irritants to the sensitive skin. Skin irritation can also be caused by air fresheners, soaps, or lotions that are heavily perfumed.

3. Medicines

The use of medicines like antidepressants, birth control pills, steroids, etc., by breastfeeding mothers can cause acne in toddlers. However, there is limited research to establish a correlation.

4. Dietary changes

Dietary changes in a mother’s food might also cause skin problems leading to acne breakout in toddlers.

5. Hormones from maternal breast milk

Some researchers believe that the hormonal disturbances in the mother might get passed to babies via breast milk. However, this requires further research (5). Drooling of saliva from the baby’s mouth can lead to acne. Also use of rough fabric may irritate the sensitive skin of the baby. In some toddlers, the acne might happen due to hormonal changes. The doctor might recommend blood tests in case hormonal abnormalities are suspected to be the cause (3).

How Do You Treat Acne in Toddlers?

Acne does not need treatment in toddlers. It is a self-limiting condition and resolves by itself. Treatment might be required only in a few rare cases. Dr. Anna H. Chacon, a board-certified dermatologist from Miami, Florida, says, “You should contact a doctor if your child has moderate-to-severe acne, painful cysts, or scars.” Establishing the cause of acne is essential in designing the treatment plan. The doctor will identify the underlying cause and suggest treatment accordingly. The following is the commonly proposed treatment plan for acne in toddlers (3).

Topical application of benzoyl peroxide might be recommended. Application of topical antibiotic ointments such as erythromycin might help in treating acne.

If the topical application does not help, the doctor might prescribe oral antibiotics like erythromycin, trimethoprim, etc.

The doctor will plan the acne treatment only on the basis of the underlying pathology. If some hormonal issues are suspected, then the endocrinologist will plan the treatment accordingly.

Tips To Reduce And Prevent Acne In Toddlers

Taking the following precautions can help reduce and prevent further the occurrence of acne in toddlers.

Avoid scrubbing the area of the pimples with a towel. Keep the baby’s face clean with warm water. Do not squeeze the pimples since it might exacerbate the spread of acne lesions. Teach your toddler not to scratch or pop the pimples. Do not use lotions. Do not use over-the-counter (OTC) acne products since they might be harsh for your toddler’s skin. Use a bar of mild soap without fragrance to bathe the toddler. Use mild and gentle laundry detergents for the toddler’s clothes. Document the episodes of acne flare-out in the toddler and correlate it with the food you consumed. Your toddler might show a reaction to substances from the food items that passed through the breastmilk. Avoid chemical-based oily lotions and creams for the baby. Use prescription-based mild products that are specifically designed for toddlers. You should consume a healthy and well-balanced diet to prevent acne in toddlers.

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