areas every day for 3 days in a row. Treatment was continued as the patient had no adverse reaction to the cream. Currently, there is no clinical data to support safe topically applied salicylic acid usage in babies and/or demonstrating low or no risk of topical salicylate toxicity.
Preadolescent Acne
Preadolescent acne occurring in children at 7 to 12 years of age, or up to menarche for females, has become more common; however, only a few epidemiological studies are available in this population.13,21-26
Children with preadolescent (≥7 to 12 years) acne require a directed medical history and physical examination.5,6 The medical history should include the age of acne onset, disease duration, growth parameters, and age of onset for any early signs of virilization.21 The physical examination should include height, weight, types, location of acne, and signs of puberty (body odor, axillary and pubic hair, breast buds, enlarged phallus, testis, or clitoris). Laboratory evaluation is indicated for patients with other signs of early virilization (in the US, pre-8 years of age in girls and pre-9 years of age in boys.) Hand and wrist X-ray for bone age is a simple, practical initial examination.5,6 A workup and a referral to a pediatric endocrinologist are warranted for mid-childhood acne (ages 1 to < 7 years).5,6,21 This type of acne is uncommon, and patients need to be examined, especially if displaying secondary sexual characteristics.5,6 Physicians should collect patient history on their diet and consider any potential contributing factors to their acne.9
Preadolescent Acne
Preadolescent acne occurring in children at 7 to 12 years of age, or up to menarche for females, has become more common; however, only a few epidemiological studies are available in this population.13,21-26
Children with preadolescent (≥7 to 12 years) acne require a directed medical history and physical examination.5,6 The medical history should include the age of acne onset, disease duration, growth parameters, and age of onset for any early signs of virilization.21 The physical examination should include height, weight, types, location of acne, and signs of puberty (body odor, axillary and pubic hair, breast buds, enlarged phallus, testis, or clitoris). Laboratory evaluation is indicated for patients with other signs of early virilization (in the US, pre-8 years of age in girls and pre-9 years of age in boys.) Hand and wrist X-ray for bone age is a simple, practical initial examination.5,6 A workup and a referral to a pediatric endocrinologist are warranted for mid-childhood acne (ages 1 to < 7 years).5,6,21 This type of acne is uncommon, and patients need to be examined, especially if displaying secondary sexual characteristics.5,6 Physicians should collect patient history on their diet and consider any potential contributing factors to their acne.9
CASE 3
An 8-year-old girl presents with mild preadolescent acne on her face. The patient presented at the pediatric clinic as the condition bothered her (Table 3). No skin care was used until now. The patient and her parents received an acne handout informing them about the disease, treatment, and maintenance approaches. A ceramide-containing 4% BPO foaming wash with a facial moisturizing lotion was recommended to be used in the morning and the facial moisturizing lotion alone in the evening. The girl and her parents were interested in the acne skincare regimen, which also provided acne maintenance.27,28 The advisors agreed that when acne is addressed early on, it can set children up for later success.
