Newborn acne on the face

Acne neonatorum or the scientific term "milia" is white or yellow pimples on the skin of a baby, which are located mainly on the face and cause concern in parents precisely because of their appearance. Outwardly, they resemble pustules, but this is not at all the case and there is no need to be afraid right away. It is necessary to distinguish when such pimples do not entail danger, and when it is necessary to contact a doctor.

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Epidemiology

The epidemiology of manifestations of sexual crisis in a child is such that only 76% of all children have some manifestations. About 19% of cases of sexual crisis correspond to the development of milia or acne neonatorum. This is not as common as other manifestations and is more common in premature babies. Today, less than 3% of all cases of milia are complicated by infection, which indicates an increase in parents' knowledge of infant skin care.

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Causes of acne in newborns

In most cases, infant acne is caused by blockage of the sebaceous ducts. This condition in a newborn baby is considered normal if this is the only reason for its appearance. But it is necessary to understand what features of the skin of a newborn baby contribute to the development of acne.

First of all, it should be noted that the baby's skin is very thin and the sweat and sebaceous glands do not fully develop until the moment of birth. This is a kind of danger mechanism, since the child cannot eliminate pathogens that accumulate on the surface of the skin. The sebaceous glands of a newborn are embedded in the dermis, but they do not branch and do not have an outlet on the surface of the epidermis. During the process of skin growth, cells multiply and full-fledged excretory ducts are formed, like in an adult. This happens by the end of the first month of the baby's life. Cell multiplication and development of excretory ducts occurs under the influence of the mother's sex hormones. With their normal level, everything ends well and by the end of the neonatal period the glands develop. One of the reasons for the blockage of the glands is considered to be an excess of sex hormones in the mother. During pregnancy, for the normal development of the fetus, it is necessary to have a sufficient amount of estrogens and progesterone, regardless of the sex of the child. This is necessary for the development of the genitals, but also for the formation of many glands and their normal function. Therefore, during pregnancy, the level of mother's hormones increases to provide for both mother and fetus. Excess of sex hormones can also give clinical manifestations in the form of a sexual crisis. This leads to premature closure of the glands and accumulation of secretion before birth. Over time, normalization of hormone levels after birth and gradual growth of the skin leads to the opening of the ducts and all the secretion comes out. The pathogenesis of the formation of the acne process itself indicates physiological changes in the skin and proves that there is no need for external intervention.

Such acne is one of the elements of the sexual crisis of the newborn. The sexual crisis is characterized by the fact that after birth the baby may have some manifestations from the genitals, skin, mammary glands. This is considered a completely normal phenomenon and does not require any treatment. Along with acne, there may be engorgement of the mammary glands, vaginal discharge in girls, which is also often expressed together with blockage of the glands.

There are pathological causes of acne development with external infection of the ducts. Then the direct cause is microorganisms that get through the baby's thin skin and contribute to the development of the inflammatory process. Normally, if acne is not touched, it opens itself after some time. But if you squeeze it out or do something, it can become infected. The baby's thin skin can easily be injured and this is the cause of acne infection and the formation of infected acne. Therefore, it is important that parents do not use any methods to treat or injure the skin.

Speaking about excess hormones, it is important to remember that this does not happen to every woman and not all newborns have manifestations of a sexual crisis and acne in particular. Therefore, it is necessary to identify risk groups for this pathology in order to know about the possibility of such manifestations on the skin. If the pregnancy was planned in advance, then hormonal screening is carried out and, if problems are detected, the hormone levels are adjusted. In such cases, no problems usually arise with a planned pregnancy. The risk group includes women who have miscarriage or a threat of miscarriage, which requires external intervention. The reason for this condition in most cases is a lack of mother's sex hormones for implantation of the embryo and normal blood circulation. Therefore, if there is a threat, additional hormone replacement therapy is carried out. If the amount of such therapy exceeds the norm, the hormones affect the baby and cause symptoms. Women with concomitant pathology also belong to the risk group. If there is late gestosis, this can also cause the appearance of symptoms of a sexual crisis. Women with elevated testosterone levels or who are on hormone therapy for any other reason may develop hormonal imbalances that lead to acne.

Based on the possible causes, two conditions should be distinguished - physiological acne of newborns and acne when they are infected. The first condition is not even a pathology, but the second develops with improper care of the baby's skin. Therefore, it is very important to know the clinical manifestations of certain conditions and to properly treat them, if necessary.

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Symptoms of acne in newborns

The first signs of milia appear more often in the first or second week of a child's life. It all starts with the appearance of small white dots on a red background. The rash is localized on the cheeks, chin, forehead. Sometimes the process can spread to the body, but this is rare. Symptoms of acne are characterized only by a specific appearance. They appear against the background of slight reddening of the skin and look like white dots that have a white rod in the center. This is very similar to the appearance of an acne, which is why it is called that, but there is no inflammatory basis in the gland itself. Therefore, the name justifies only the appearance. A characteristic feature of acne is that the child has no other symptoms. These pimples do not cause itching, pain or disturbance of the condition. The child sleeps well, takes the breast, is not capricious more than usual and the temperature is within the normal range.

Sometimes such acne can become infected even without external intervention. Then symptoms of fever appear - in infants, this can be a temperature reaction of up to 38 degrees and no higher, which at first glance does not seem like a serious temperature, but this is not the case. In such children, the thermoregulation center is not sufficiently developed, so such hyperthermia is already considered serious. There are also changes in the general condition - capriciousness, crying, refusal to feed, sleep disturbance. The acne itself can also change its appearance when infected - they become larger, have a more yellow color and some can open with the release of pus and the formation of ulcers. These are serious symptoms that require immediate action.

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Stages

The stages of milia development do not have any particular dynamics, since the process itself occurs when the ducts open and the sebaceous gland secretion comes out. If we are talking about infected acne, then everything begins with the infiltration process, and then moves to the abscess stage.

Whiteheads in newborns are manifestations of milia, but other types, such as infantile inflammatory acne, have an inflammatory mechanism of formation. They develop with persistent infection and last until the third or fourth month of a child's life. Such acne requires careful differential diagnostics.

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Complications and consequences

The most frequent and serious complications that can occur with acne are inflammation with rapid spread of infection throughout the skin. With external skin defects, microorganisms quickly spread deep and from there infect tissues. This leads to a pronounced and rapid inflammatory reaction of the entire skin, which threatens sepsis in the newborn. A pronounced inflammatory reaction entails intoxication and rapid development of toxic shock. Speaking about the consequences of acne, they can be very serious, since any changes in the skin are very dangerous in terms of rapid spread of infection. This proves the importance and extreme necessity of proper care of the baby's skin in the first month of his life, and especially when acne appears.

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Diagnostics of acne in newborns

Diagnosis of milia involves not only establishing a diagnosis, but also adequate differential diagnostics, which allows you to calm the mother or, on the contrary, whether you need to worry. First, it is necessary for the mother to determine when acne is normal, and when it is worth contacting a doctor. Diagnosis of such dangerous conditions for the child consists of determining the general condition of the child. First, if the child has a normal temperature, he sleeps well, sucks the breast and behaves normally, then most likely such acne is milia. Then there is no need to worry. If something is wrong, the child screams or acne bothers the mother, then it is imperative to seek advice. Very often, the peak of acne rashes falls on the third week of the child's life, when colic begins and daily loud crying for several hours coincides with the appearance of milia. Then it is very difficult to determine what exactly bothers the child and an experienced look is needed.

The main method of diagnosing acne in newborns is an objective examination. Any pediatrician or neonatologist can tell what kind of rash it is by simply examining it based on experience. If the diagnosis of milia is objectively confirmed, then no tests or other studies should be carried out, remembering that any invasive intervention methods are dangerous because they cause even more harm to the child.

It is very important to differentiate between neonatal acne and allergic rash, especially if both are present. Allergic rash, like acne, is localized on the cheeks. Both pathologies have reddening of the skin, but the elements of the rash are different. Acne has the appearance of elevations on the background of hyperemic skin, which have a white dot in the center. Allergic rash is also on the background of red skin, but the elements themselves are red and have an irregular shape or in the form of a dot without changes in the center. The rash is usually symmetrical in allergies and can spread to the extremities, and acne has a one-sided localization - at the wings of the nose, or on the cheek, or forehead, not having a tendency to widespread.

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Differential diagnosis

It is also necessary to differentiate with inflammatory acne, which requires treatment. Such acne also has a white dot in the center, but it increases over time and it is clear that pus is forming in the center. This causes painful sensations in the baby and he is capricious, does not allow touching the affected areas of the skin. This is the main differential sign for the mother first of all, which requires attention.

Treatment of acne in newborns

Treatment of acne of physiological etiology, that is, milia, does not imply special means or medicines - it is important for every mother to remember. First of all, it is necessary to organize proper skin care. You need to bathe a baby with acne at home, in warm and clean boiled water. No herbs should be added to the water, as this can cause additional sensitization and an allergic reaction. It is very important to use only baby soap and shampoo without special additives and antiseptics, as this additionally dries the skin. That is, skin care should be the same as for the skin of a healthy newborn baby. You cannot squeeze or scratch acne - this significantly increases the risk of complications and additional damage. The use of antiseptics, ointments and medicinal creams is not justified, since all products create a layer of impermeable film that covers the baby's skin and does not allow it to breathe. Therefore, when physiological acne forms, there is no need for special treatment - they will go away on their own after two weeks from the beginning. If there is even the slightest risk of infection or clinical signs of it, then it is imperative to apply treatment as early as possible to avoid complications. For the purpose of treatment, local therapy is used, and then systemic agents.

1. Eplan is an ointment that can be used as a local remedy for the treatment of infection and prevention of complications in acne in newborns. The composition of the drug includes glycerin, triethylene glycol, carbitol. Due to this composition, the drug has a pronounced softening, anti-inflammatory, bacteriostatic, regenerating effect. How to use the ointment - you need to lubricate the affected areas of the skin twice a day. The dosage is small - a small grain of ointment should be squeezed out and this should lubricate all the affected areas with a thin layer, avoiding the area around the eyes. Side effects - there may be local allergic reactions, systemic reactions have not been noted, since the drug enters the systemic bloodstream little.
2. Sudocrem is a topical skin care product that can be used to treat acne at risk of inflammation. The product contains paraffin, zinc oxide, oils and acids. This composition promotes healing of acne during its maceration, dries the skin and forms a waterproof film that protects all layers of the skin from further damage. How to use the product – it is necessary to apply a thin layer so that the film does not contribute to severe drying of the skin. Dosage – it is recommended to use in the morning once a day. Precautions – avoid contact with mucous membranes.
3. Bepanten Plus is a cream that contains panthenol and chlorhexidine. This composition of the drug has not only a healing effect, but also an antibacterial one. Chlorhexidine is an active antiseptic that is effective against staphylococci. These bacteria are the most common causative agent of skin infectious inflammations in newborns, so the use of the drug is quite justified in this case. Panthenol, when acting on the skin, releases pantothenic acid, which, when activated, acts like a vitamin and restores the structure of damaged skin cells. Method of application: only externally on areas of the skin with a thin layer. The dosage should not exceed five grams per day. Side effects can be in the form of blisters or, with a larger area of use, respiratory or cardiovascular disorders.
4. Regecin is a gel used to treat acne and prevent the spread of bacteria. The gel contains zinc chloride and sodium hydroxide, which have an antiseptic and drying effect. Due to this, the drug can be used for severe irritation and the formation of weeping skin changes. The method of application of the drug is twice a day. The dosage should not exceed three grams. It should be applied by lubricating a thin layer of skin. Side effects may be local in case of an allergic reaction to the components of the drug.
5. Skin-cap is a product for external use in the form of a gel and external aerosol. The product contains zinc and other active substances that have a pronounced antiseptic effect. The method of application of the product is external, but it is impossible to use a large amount due to the risk of burns. Before using the product, it is recommended to conduct a test on unaffected areas of the skin. Side effects other than allergies may manifest themselves as minor burns.
6. Systemic treatment of acne when infected and at risk of developing streptoderma and staphyloderma of the skin is mandatory. Therefore, the use of systemic antibiotics is a prerequisite for the treatment of inflammatory acne lesions in newborns. Given the range of possible pathogens, antibiotics from the macrolide group are used, the effectiveness of which in newborns is balanced by safety.

Clarithromycin is an antibacterial agent from the macrolide group. Among the known drugs, it has the maximum activity against intracellular parasites and microorganisms of the staphylococcus and streptococcus group, that is, it acts on possible pathogens of skin inflammatory infections, thus interrupting the persistence of the pathogen. Clarithromycin has a long half-life. The method of administration depends on age and can be in the form of a suspension or tablets, but in the initial stages it is better to start taking intramuscularly in parallel with another antibiotic. It is prescribed to children over 3 years old and the dosage is 10 mg / kg / day on the first day, from the 2nd to the 7-10th day - 5 mg / kg / day once a day. A mandatory condition is to use two hours after a meal or an hour before it. The course of treatment is 5-7-10 days. Side effects of azithromycin include paresthesia, impaired skin sensitivity, numbness of the arms and legs, tremor, impaired bile flow, and dyspeptic symptoms. Precautions: do not use in case of cholestasis or gallstone disease.

Vitamins can be used by a mother when breastfeeding a child, but a direct positive effect on the reverse development of acne has not been proven. The best source of vitamins and the greatest benefit for a newborn child with acne can be considered a balanced diet with sufficient amounts of vitamins in food.

Such medications, both local and systemic, can be used only if there are indications in the form of inflammatory complications, and self-medication and routine unjustified use of ointments, creams, antibiotics can lead to unforeseen consequences.

Folk remedies for acne in newborns

When talking about folk remedies for acne in newborns, it is important to remember that all remedies can only be used after consulting a doctor. It is important to treat not only the child and skin changes, but also, first of all, the mother - her hormonal background during breastfeeding plays a very important role in recovery and solving all problems.

1. The most active vitamins for the skin are considered to be vitamins A and E. They promote active healing and restoration of epidermal cells. But the use of vitamins in high therapeutic concentrations can be harmful to the baby, so folk remedies are used that allow you to replenish vitamin reserves. For this purpose, it is recommended to introduce fruit juice into the diet of a nursing mother. To do this, take an equal amount of freshly prepared apple juice, carrot and pumpkin and mix. You need to take forty grams in the morning once a day. It is necessary to take into account that the child's body can take this for an allergen, so you need to carefully start with half the dose.
2. Bathing healthy children in herbs is not recommended today, as it increases the risk of developing allergies. But wiping the child's face with warm boiled water with herbs for acne is very useful. This does not allow you to inhale the vapors of these herbs, and the effect on the skin of the face is maximally effective. For this, use the herb of succession and calendula - you need to first start with one herb, and then add another one in turn. You need to wipe the child's face carefully so as not to rub and cause irritation. It is better to do this two or three times a day.
3. When bathing, adding potassium permanganate to the water gives a good effect. It has an antiseptic effect and prevents the proliferation of pathogenic flora. For a weak solution, take one gram of powder per liter of water and dilute, then add this solution to the bathing water. The water should have a slightly noticeable pink tint. It is important to remember that such water should not get on the mucous membranes and in the eyes.

Herbal treatments can only be used through "transmission" from the mother, as the use of herbs on a child is dangerous and unpredictable.

1. Mom can drink herbal tea - chamomile should be steeped in water and drunk warm at least twice a day. It is important to remember that it is better to add a little sugar and a little lemon juice, avoiding honey.
2. Tea from succession and viburnum also helps to cleanse the skin, as it contains many useful flavonoids. To prepare the tea, take thirty grams of each herb and pour a liter of water. Take one hundred grams three times a day.
3. Aloe has a lot of cleansing and antiseptic substances that normalize the skin's water balance and eliminate duct blockage more effectively than any cosmetic ointments. The use of aloe or Kalanchoe in newborns is not recommended. However, given the properties of such a medicine, it can be used for mothers. To do this, you need to wash an aloe leaf and squeeze fresh juice out of it. Add a few drops of lemon juice and take ten grams of aloe juice once a day.

Homeopathy can also be used to treat acne in babies, which prevents the risk of complications and other dangerous skin conditions. Preventive use of homeopathic remedies is especially recommended before birth for mothers at risk or those with problems with their own skin.

1. Pulsatilla is an organic homeopathic herbal preparation. It is used to treat acne in children whose mothers have light hair and soft facial features. The method of administration of the preparation is oral in the form of granules for mother's use. Dosage - one granule five times a day. It is recommended to use a dilution of no more than one to six. Side effects are possible in the form of increased salivation and nausea.
2. Gepar sulfur is a homeopathic preparation from the group of inorganic preparations. It is used to treat acne that is prone to complications against the background of active observation for a long time. The method of using the preparation is in the form of drops of a certain dilution. The dosage in case of taking drops is one drop once a day for mother to take. Side effects are not frequent.
3. Cutis compositum is a homeopathic remedy of natural plant origin based on herbs. The drug can be used to treat acne that has a protracted but uncomplicated nature. The method of using the drug is to use a homeopathic solution in ampoules, dissolving them in clean water. Dosage is five drops per glass of water for the mother, and for the child one drop should be dissolved in a glass of warm boiled water, then you need to wipe the face and areas with acne localization. Side effects can be in the form of insomnia in the mother or stool disorders with diarrhea in the child
4. Gormel is a homeopathic remedy of natural plant origin, which is recommended for use specifically for newborns born to mothers with hormonal disorders. This plant is primarily a systemic remedy for normalizing hormonal levels and restoring them not only in the baby, but also in the mother in the postpartum period. The method of using the drug is for the mother in the form of drops, dissolving them in clean water. Dosage - three drops per fifty grams of water. Side effects can be in the form of increased pressure, tachycardia, insomnia. Stool disorders in the form of diarrhea are often observed. Precautions - cannot be used if there is an allergy to coniferous trees in the family.

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Prevention

Prevention of complications is very simple and consists of proper skin hygiene and minimizing interventions. It is important to consult a doctor when such changes occur, and then an experienced specialist will correctly determine the child's condition and the need for intervention. The most important thing is not to squeeze acne and not to lubricate it with anything unless there are indications for this.

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Forecast

The prognosis for resolving the situation is favorable, since this is a transient condition of the newborn, which passes without treatment after two to three weeks.

Acne in newborns is a physiological change in the skin caused by a disruption in the outflow of secretion from the baby's sebaceous glands. This condition is quite common and does not require any additional interventions. If there are no complications, there is no need to treat this condition. The main thing is proper care of the child, mother's nutrition and father's attention.