A pattern of innate inflammation is considered to trigger acne by direct and indirect multifactorial, complex, and interrelated mechanisms.5-8 The mechanisms include generating chemotactic and pro-inflammatory factors, stimulating inflammatory mediators.9,10 The initial inflammatory response may progress into inflammatory patterns, which lead to acne lesion formation up to and including scar formation in some patients.9
The presence of pediatric acne may be a manifestation of underlying pathology.5,6 Workup when necessary is based on age and physical findings, including morphology and distribution of acne lesions and physical condition in relation to age.5,6
The pathogenesis of pediatric acne is thought to be similar to acne at all ages, although the approach to treatment may differ due to the state of skin maturity and concerns about the safety and efficacy of various therapies in young age groups.5-8
Treatment recommendations5,6 for mild pediatric acne may start with topical benzoyl peroxide (BPO) or a low strength topical retinoid. Other options are topical fixed combination therapy such as BPO plus antibiotic, BPO plus retinoid, or a combination of BPO, antibiotic, and retinoid.5,6 Pediatric treatment recommendations5,6 for moderate acne may start with topical treatment similar to mild conditions.5,6
A further option may be an oral antibiotic combined with topical retinoid plus BPO.5,6 A major consideration to changing the type or the formulation of the topical treatment is an inadequate response to therapy.5,6 For females, hormonal therapy may be an option.5,6,13,14 A fixed combination topical treatment may be combined with an oral antibiotic for severe pediatric acne.5,6 If the response to treatment is inadequate, consideration to changing the oral antibiotic or oral isotretinoin may be given; consider hormonal therapy for females.5,6 The advisors noted that of the acne prescription treatments in children younger than 12 years of age are considered off-label.15
Nonprescription acne products and skincare using cleansers and moisturizers should play a necessary part in acne treatment.5,6,10,14 However, within the available acne treatment consensuses, there is a knowledge gap on nonprescription cleansers and moisturizers in pediatric acne.6 To improve pediatric acne patients’ outcomes giving it more attention from health care providers treating children, the advisors defined various expressions of pediatric acne to educate and tailor nonprescription acne treatment and skincare using cleansers and moisturizers.
The presence of pediatric acne may be a manifestation of underlying pathology.5,6 Workup when necessary is based on age and physical findings, including morphology and distribution of acne lesions and physical condition in relation to age.5,6
The pathogenesis of pediatric acne is thought to be similar to acne at all ages, although the approach to treatment may differ due to the state of skin maturity and concerns about the safety and efficacy of various therapies in young age groups.5-8
Treatment recommendations5,6 for mild pediatric acne may start with topical benzoyl peroxide (BPO) or a low strength topical retinoid. Other options are topical fixed combination therapy such as BPO plus antibiotic, BPO plus retinoid, or a combination of BPO, antibiotic, and retinoid.5,6 Pediatric treatment recommendations5,6 for moderate acne may start with topical treatment similar to mild conditions.5,6
A further option may be an oral antibiotic combined with topical retinoid plus BPO.5,6 A major consideration to changing the type or the formulation of the topical treatment is an inadequate response to therapy.5,6 For females, hormonal therapy may be an option.5,6,13,14 A fixed combination topical treatment may be combined with an oral antibiotic for severe pediatric acne.5,6 If the response to treatment is inadequate, consideration to changing the oral antibiotic or oral isotretinoin may be given; consider hormonal therapy for females.5,6 The advisors noted that of the acne prescription treatments in children younger than 12 years of age are considered off-label.15
Nonprescription acne products and skincare using cleansers and moisturizers should play a necessary part in acne treatment.5,6,10,14 However, within the available acne treatment consensuses, there is a knowledge gap on nonprescription cleansers and moisturizers in pediatric acne.6 To improve pediatric acne patients’ outcomes giving it more attention from health care providers treating children, the advisors defined various expressions of pediatric acne to educate and tailor nonprescription acne treatment and skincare using cleansers and moisturizers.
METHODOLOGY
Role of the Panel
A panel of 7 experts in dermatology in pediatrics who treat pediatric acne patients convened a meeting on August 28, 2021. They reviewed and discussed the literature on nonprescription acne treatment and skincare using cleansers and moisturizers for this population (Figure 1). During the meetings’ workshop,
A panel of 7 experts in dermatology in pediatrics who treat pediatric acne patients convened a meeting on August 28, 2021. They reviewed and discussed the literature on nonprescription acne treatment and skincare using cleansers and moisturizers for this population (Figure 1). During the meetings’ workshop,
