Pre-adolescent acne requires different treatment regimens

Puberty at an earlier age might be the reason a growing number of pre-adolescents experience acne, and treatment strategies for this age group depend on severity, according to a presentation at the American Academy of Dermatology Summer Academy Meeting in New York.

Andrea L. Zaenglein, MD, FAAD, professor of dermatology and pediatrics at Penn State Hershey Medical Center, is co-author of recently published acne guidelines for children of all age groups (Eichenfield et al, Pediatrics. May 2013). Researchers believe earlier puberty onset causes hormones to trigger the start of acne sooner, according to a press release.

Pre-adolescents (aged 7 to12 years) experience acne that is not typically severe and includes comedones on the forehead, nose and chin, Zaenglein said. Larger, inflammatory lesions are uncommon in the age group.

While therapy can control acne for years, Zaenglein advised physicians to monitor the condition throughout puberty for signs that acne may be worsening, since early onset of comedonal acne can predict more severe acne in teens or adults.

Dermatologists should consider the patient’s age and type of acne when determining treatment, Zaenglein said. Over-the-counter benzoyl peroxide products should be effective for mild acne. If patients are unresponsive, a topical therapy combination of benzoyl peroxide and antibiotic or retinoid might be considered. Isotretinoin can safely be used by pre-adolescents if acne does not respond to topical and oral antibiotic therapy.

“Acne … can be especially distressing for kids and parents when it develops sooner than expected,” Zaenglein said. “It is important for parents not to put off treatment thinking acne will go away on its own, especially if a child has severe acne or scarring. Puberty lasts several years, as does acne, so proper treatment is essential.”

Disclosure: Dr. Zaenglein has served on advisory boards of Galderma, Valeant and Promius, has been a speaker for Galderma, and has participated in clinical trials for Astellas, Galderma, Medicis, Photocure and Valeant.

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