Acne: prepubertal

Prepubertal acne is relatively common, and is generally not associated with significant underlying endocrinopathy. 

This chapter is set out as follows:

• There are usually no significant underlying endocrinopathies and, in the absence of precocious puberty or other developmental abnormalities, investigations are not needed

• It is more common in boys and presents between the ages of three and 18 months, and may last up to the age of three years

• The severity is usually mild-moderate but occasionally can be severe
• The face is the most frequently affected site, often with a mixture of comedones, papules and pustules
• Nodules and scarring occasionally occur 

• Refer to the acne section in the concise guidelines. Tetrayclines must be avoided in children aged under 12 years

• On occasions acne can be severe with nodules or scarring, such patients should be referred urgently for consideration of treatment with isotretinoin