[1][2] Typical symptoms include inflammatory and noninflammatory lesions, papules and pustules most commonly present on the face.

[4] During the first 6–12 months of age, there is increased sebum production stimulated by luteinizing hormone (LH) and testosterone of testicular origin that stops after this period until adrenarche.

[3][4] It is suggested that the fetal adrenal gland along with testicular androgen could be the cause of infantile acne.

During the neonatal period, there is increased sebum production through an enlarged zona reticularis (an androgen producing area) on the fetal adrenal gland that gradually decreases to very low levels at around 1 years of age, coinciding with when infantile acne tends to resolve.

[3] Other conditions that should be considered include periorificial dermatitis, keratosis pilaris, sebaceous hyperplasia and infections.

[4] Benzoyl peroxide (BPO) is first line for mild cases of infantile acne due to its safety and effectiveness.

BPO concentrates within cells of sebaceous follicles where it generates free radicals to oxidize proteins in bacteria such as P. acnes.

[4][2] Topical retinoids both alone and in combination are also first line for treating mild to moderate cases of acne.

[9] Retinoids prevent formation of comedones and promote comedolysis by binding to retinoic receptors and normalizing growth of keratinocytes.

[11] These bacteriostatic antibiotics interfere with bacterial protein synthesis, preventing formation of free fatty acids by these bacteria that cause inflammation.

[10] In severe cases of infantile acne, especially with the presence of nodules and cysts with risks of scarring, oral antibiotics may be used.

[4] First line therapy is erythromycin with sulfamethoxazole-trimethoprim as a secondary choice in cases of P. acnes resistance.