A skin problem that mortifies many teens is now appearing in younger kids.
More pre-adolescent children, ages 7 to 12, are developing acne, dermatologists say.
"It is common for 9- to 11-year-olds to have early acne, and sometimes this can be quite significant," says Lawrence Eichenfield, chief of pediatric and adolescent dermatology at Rady Children's Hospital in San Diego. The earlier onset of acne has been linked to the start of puberty at younger ages, he says.
Boys are experiencing puberty six months to two years earlier, according to a study last year in the journal Pediatrics, and a 2010 study found that the percentage of girls who had breast development at ages 7 and 8 is greater than for girls born 10 to 30 years earlier.
During puberty, a rise in hormones can make skin and hair oily, contributing to clogged pores and acne.
Acne, a common skin problem in teens and adults, can include whiteheads, blackheads, pimples, nodules and cysts. It can leave blemishes and scars, and it can cause emotional distress. It "can have a tremendous negative psychological impact," Eichenfield says.
Pre-adolescent acne can progress from whiteheads to inflamed bumps. It occurs mostly on the forehead, nose and chin, the so-called T-zone.
Early acne is a little more common in girls than boys, Eichenfield says. In girls, the stimulation of the adrenal-related hormones tends to start earlier.
Pre-adolescent acne that is mild can be treated with over-the-counter products, such as benzoyl peroxide gels and washes. More severe acne can be treated with oral antibiotics and topical medications by prescription; topical treatments include antibiotics and retinoids. Therapies can combine some of these products.
Back-to-school physical exams are a good time for parents to address skin concerns with their kids' doctors, dermatologists say. They can help assess whether the acne is significant enough to start therapy, says Eichenfield, professor of pediatrics and medicine at the University of California-San Diego.
Doctors also can check whether a child has a hormonal imbalance, says Andrea Zaenglein, professor of dermatology and pediatrics at Penn State Hershey Medical Center in Hershey, Pa.
A girl's early onset of whiteheads and blackheads can be a predictor of more severe acne in adolescence, she adds.
Through the American Acne and Rosacea Society, Eichenfield and Zaenglein helped develop guidelines for the diagnosis and treatment of pediatric acne. The guidelines recommend treatment by age and acne severity. The American Academy of Pediatrics endorsed and published the guidelines in Pediatrics in May.
Latanya Benjamin, a dermatologist at Lucile Packard Children's Hospital at Stanford in California, also says she sees "more and more patients coming in for treatment." Benjamin, an assistant clinical professor of dermatology and pediatrics at Stanford School of Medicine, says it's hard to determine whether greater awareness contributed to the increase.