This summary discusses acne in neonates. Acne in infants and acne vulgaris in adults and children are addressed separately.
Neonatal acne, or neonatal cephalic pustulosis, is a very common acneiform eruption occurring on the face of neonates (ages 0-6 weeks). Many separate these two conditions as the following: neonatal cephalic pustulosis for a solely papulopustular eruption, often associated with Malassezia species, and neonatal acne for eruptions that include open comedones or nodulocystic lesions. This distinction is usually academic, as both tend to be very mild and spontaneously resolve by age 3-6 months without residual sequelae.
Neonatal acne
Alerts and Notices
Synopsis
Codes
ICD10CM:
L70.4 – Infantile acne
SNOMEDCT:
49706007 – Infantile acne
L70.4 – Infantile acne
SNOMEDCT:
49706007 – Infantile acne
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
Pustular eruptions in a well-appearing neonate:
Pustular eruptions in a toxic-appearing neonate:
- Miliaria rubra (also known as prickly heat) and miliaria pustulosa – Identical to benign cephalic pustulosis but involves more of the skin folds (neck) and areas exposed to heat or occlusion.
- Milia – More often on the nose and are white as opposed to erythematous.
- Congenital candidiasis – More widespread and may be associated with infection of the mother, umbilical cord, or placenta.
- Eosinophilic pustular folliculitis – More scalp involvement, rapidly crusts over, and is pruritic.
- Staphylococcal folliculitis – More widespread and favors moist, occluded areas.
- Scabies – Pruritic and more widespread.
- Keratosis pilaris – Rough surfaced.
- Nevus comedonicus – Unilateral and linear.
- Erythema toxicum neonatorum – More widespread and transient.
Pustular eruptions in a toxic-appearing neonate:
Best Tests
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Management Pearls
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Therapy
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References
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Last Updated:01/06/2022
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Neonatal acne