Acne in Toddlers: When to Call a Doctor

Many people associate acne with adolescence. And the truth is, most teenagers and young adults experience at least one breakout at some point in their lives. But teens aren’t the only ones who develop acne. Up to 50 million Americans deal with the skin condition every year—and that includes some infants and young children.

If you are worried about your child’s skin, read on. In this article, I will explain what toddler acne is, the symptoms and causes, and treatments that may help. I’ll also detail what other conditions resemble acne so you can work with your healthcare provider to get to the bottom of your child’s problem and clear up their skin.

What Is Toddler Acne?

Acne (scientifically called acne vulgaris) is an inflammatory skin condition that starts when one or more sebaceous (oil) glands at the base of your hair follicles become stopped up with oil and dead skin cells. When clogged glands become infected with bacteria, red bumps or pustules called pimples can form on the skin’s surface. 

Although it’s less common than teenage acne, infants and young children can develop acne or acne-like symptoms. Pediatricians divide childhood acne into four subgroups, each defined by how old a child is when they first develop pimples. 

• Neonatal cephalic pustulosis: Sometimes called “baby acne,” neonatal acne affects newborns and infants. About 20% of babies (ages 0-6 weeks) develop small red or white bumps on their face, scalp, chest, or back. It normally clears up quickly—usually in just a few weeks.

• Infantile acne: Acne on older babies (ages six weeks-12 months) is less common, affecting just 2% of children. It usually presents on a baby’s face and can be more severe than neonatal acne. 

• Mid-childhood acne: Young children (ages 1-7 years) very rarely develop skin problems like acne. When they do, it can indicate another, more serious underlying medical condition. 

• Prepubertal acne: When an older child (ages 7-12) develops a blackhead or whitehead, it may be a very early sign that they are beginning puberty. If the acne becomes severe, though, it can indicate another, more serious underlying medical condition.

Symptoms of Toddler Acne

Mid-childhood acne, the kind that affects toddlers and young children, can be challenging to identify. Acne has a variety of symptoms that present differently in each child. These symptoms are also easily confused with those of other childhood illnesses and conditions.

Symptoms of mid-childhood acne include: 

• Small, red bumps on the skin surface (papules)
• Solid or skin-colored bumps on the skin surface (nodules)
• Large, painful bumps located deep under the skin (cysts)
• Open lesions on the skin surface (blackheads)
• Closed lesions on the skin surface (whiteheads)

Acne can appear on any part of a toddler’s body, but it is most likely to develop in areas with a high concentration of sebaceous glands such as the face, neck, chest, upper back, and shoulders. 

Causes

Acne very rarely affects toddlers. If your child has blisters or small bumps on their skin, they likely have a medical condition that is unrelated to acne. Below are the causes behind both mid-childhood acne and other conditions that present in similar ways.

Hormones

Though the precise cause of childhood acne is yet to be determined, dermatology researchers believe that, as with its adolescent counterpart, hormone production plays a role.

In specific periods of childhood, kids experience a surge in hormone circulation that can lead to overactive sebaceous glands and a minor acne breakout. For that reason, having a few pimples in very early infancy or preadolescence is expected and considered benign. 

It’s much less common for a child to develop acne during their toddler years or early childhood when their hormones should be less active. Breakouts during this period are worth medical attention; they can indicate that a child has an underlying hormonal condition or suffers from another disease that looks like acne but is unrelated.

Endocrine disorders

When a child develops mid-childhood acne, it is cause for concern. True acne on a toddler or young child often indicates an endocrine disorder, most commonly adrenal hyperandrogenism.

Adrenal hyperandrogenism is a genetic condition in which the adrenal glands excessively produce hormones related to puberty and reproduction. When a child’s body has too many hormones circulating in it too early, they can develop secondary sexual characteristics before they ordinarily would.

Blocked pores

When toddlers get too hot, they can develop heat rash (miliaria), an acne-like skin condition that occurs when sweat gets trapped beneath the skin and causes a patch of small bumps or blisters. 

Toddlers are most likely to develop heat rash during hot weather or if they wear clothes that are too tight or warm for them. The rash often appears in places with friction: the neck, elbows, armpits, and thighs. The condition can be itchy and uncomfortable, but it usually goes away on its own. 

Skin sensitivity

Children with sensitive skin can develop an acne-like reaction to one or more triggers in their environment. 

Skin irritants can range from specific fabrics, laundry detergents, and household cleaners to personal hygiene products like sunscreen, lotion, and shampoo. Pet dander, dust mites, certain grasses, cigarette smoke, perfumes, and essential oils can also cause a child’s skin to become red, raised, or irritated. 

If you have reason to believe that a substance at home or outside is causing your child’s skin condition, eliminate their contact with it. Their skin should clear up quickly.

Food allergy

Babies and toddlers with food sensitivities can sometimes develop an acne-like rash as a part of a more significant reaction. The rash can appear anywhere and is characterized by how quickly it grows and recedes. 

About 8% of children in the US have a food allergy of some kind. If your child begins to have trouble talking, breathing, or swallowing, call 911. They may be experiencing anaphylaxis, an allergic reaction that requires immediate medical intervention. 

Dermatitis

Perioral dermatitis is an inflammatory skin condition that appears as a rash around a toddler’s mouth. It is often confused with acne because it shows up as small pink bumps and fluid-filled lesions that develop and sometimes disappear and redevelop over time. 

Although the cause is not fully known, researchers believe that perioral dermatitis may be an adverse reaction to steroid treatments and other topical medications.

Viral skin condition

Molluscum contagiosum, a contagious viral infection, can produce bumps that look almost identical to toddler acne. Children pick up the virus by coming into direct contact with a contaminated person or object. It can persist for months, incubating and then erupting as a series of small, painless lesions. For most children, the condition is unsightly but not dangerous. It usually clears up on its own without leaving any scars.

Other viruses—including roseola, chickenpox, scarlet fever, keratosis pilaris, and hand, foot, and mouth disease—can produce flushing, redness, and rashes that may look similar to acne or other skin conditions. Even influenza can sometimes cause a rash, though this is infrequent. 

Lastly, children who contract COVID-19 often experience mild skin-related symptoms. If your child develops a shiny red or purple rash on their fingers or toes, swelling in their fingers or toes, or a cyst with a small amount of pus, it may be a sign of coronavirus. Keep your child isolated at home until a healthcare professional can test them for the disease.

Treatment Options

Your toddler’s treatment plan depends on the skin condition they have. If you suspect your child has from mid-childhood acne, the first step is to make an appointment to talk to your pediatrician. The doctor will look at their skin, diagnose the problem, and order further testing when appropriate to rule out underlying conditions.

Some acne-like conditions will clear up on their own. Others may require prescription medications or home remedies to heal completely. 

Medications 

Depending on the diagnosis, your doctor may recommend applying a prescription cream, lotion, or gel to the affected area to cleanse the skin and relieve symptoms. They may also prescribe an oral medication or other treatments to help clear up the skin.

Home remedies

For common skin conditions, your doctor may suggest an over-the-counter cleanser, powder, cream, or lotion. Never use a home remedy on your toddler’s skin unless you talk to your doctor and are confident that it is appropriate.

When to See a Doctor

Mid-childhood acne on a toddler is very rare and can indicate a severe medical condition. If you see a persistent rash or one or more pimples, pustules, nodules, or cysts on your toddler’s skin, make an appointment to talk to a doctor. 

Whether your toddler is diagnosed with mid-childhood acne or another condition, your pediatrician can recommend an appropriate course of action to address the skin problem and any underlying issues they may find. 

How K Health Can Help

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