Neonatal Acne

Neonatal acne can occur in up to 20 percent of healthy newborns. Lesions usually appear around 2 weeks of age and resolve spontaneously within 3 months. It is marked by small, inflamed papules across the nasal bridge and on the cheeks. Comedone formation is absent, some calling in question whether this entity is a true acne variant, but rather a variant of neonatal cephalic pustulosis. It has been shown that sebum excretion rates in newborns are transiently elevated in the perinatal period. Additionally, Malassezia sympodialis, a normal commensal on human skin, may also play a role. Some reports have demonstrated positive cultures of the pustules with Malassezia and improvement with ketoconazole cream. Although there appears to be a strong association between Malassezia and benign neonatal cephalic pustulosis, a definite causality for neonatal acne has not been proven at this time.