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Fungal Acne in Newborns: The Myth of Baby Acne

Updated: Jun 18

Neonatal acne, a skin condition affecting approximately 20% of newborns, can be mistaken for typical adolescent acne vulgaris. However, these acneiform lesions seen in newborns can be commonly due to excessive maternal hormones, elevated sebum excretion rates and a condition known as fungal acne.


Neonatal acne, also known colloquially as baby acne, is a term often used to describe acne-like skin lesions that occur due to increased production of placental and neonatal androgens. These hormones cause the sebaceous glands to enlarge and produce more sebum, leading to acne.


One of the common primary skin lesions seen in newborns that mimics acne is a condition known as fungal acne. This blog post will delve into the specifics of fungal acne in newborns, shedding light on this commonly misdiagnosed condition.


Contents:

A newborn baby with neonatal fungal acne wrapped in a blanket and lying down

Fungal Acne in Newborns

Fungal acne, or Malassezia folliculitis, is a type of skin condition caused by yeast (Malassezia) overgrowth within the hair follicles. In newborns, this condition is often associated with neonatal cephalic pustulosis, a benign skin condition characterised by small, clustered pustules usually on the face.


Causes and Risk Factors

Fungal acne in newborns is often associated with the colonisation of the skin by Malassezia species. This yeast is part of the normal skin flora but can cause skin problems when overgrown. Factors such as increased sebum production and hormonal changes in newborns can contribute to this overgrowth.


Symptoms and Diagnosis

Fungal acne typically presents as uniform small red bumps and pustules on the skin, often accompanied by mild itching. Unlike regular acne, it doesn't usually involve comedones (blackheads or whiteheads). Diagnosis is often made clinically, but in some cases, a skin scraping and culture may be needed to confirm the presence of yeast.


Treatment

The treatment for fungal acne in newborns is usually mild and aims to control the yeast overgrowth. Topical antifungal creams or lotions are commonly used. In some cases, a mild cleanser and water may be sufficient. It's important to note that neonatal acne, including fungal acne, is usually self-limiting and tends to resolve spontaneously.


Conclusion

While neonatal acne is a common term, it's essential to understand that the acne-like lesions seen in newborns are often due to fungal acne. Recognizing the signs of fungal acne can ensure prompt and appropriate treatment, helping to maintain the skin health of your newborn.


This blog post was medically reviewed by Dr Summer Zhang.


References

1. Godínez-Chaparro, J. A., & Vidaurri-De la Cruz, H. (2020). Acne in the newborn.

2. Samycia, M., & Lam, J. M. (2016).Infantile acne. Canadian Medical Association Journal. DOI: 10.1503/cmaj.160139

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