Acne in kids: Why prepubescent pimples are more common than you think

Pimples and skin inflammation is not just a struggle for teens and adults. Prepubescent acne can affect kids as young as six.  

It’s not often we associate inflamed and angry-looking acne with a child’s clear and soft skin – but prepubescent acne is just that.

Otherwise known as prepubertal acne, these pre-teen pimples can show up long before typical puberty symptoms.

“Prepubescent acne can affect children as young as six or seven years old until about age 11 or 12,” specialist dermatologist, Dr Ryan De Cruz, says.

“We’re seeing it occurring more frequently, and at an earlier age.”

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What causes acne in kids?

Dermatologists deal with acne on the daily – Australia’s Skin Health Institute says the condition affects 85 per cent of 15-24 year olds.

But how common is acne in children?

A 2021 study by the International Journal of Women’s Dermatology recorded that 3.5 per cent of its participants were affected by prepubescent acne.

With factors like hormones, lifestyle and genetics at play, dermatologist Dr Cara McDonald says there are plenty of potential causes.

“The role of hormones in acne is indisputable but they are only one factor in its development,” Dr McDonald says.

“There is a strong genetic component to acne and those who are prone develop skin-sensitivity to hormonal fluctuations.

“In most, but not all cases, there is a strong family history of acne.”

According to Dr De Cruz, the hormonal changes of young girls in particular may be another contributing factor.

“We see it more commonly in girls than in boys, and this could be because young girls are entering puberty 1-2 years earlier than they did 20 or 30 years ago,” he says.

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What does prepubescent acne look like?

More than just a smattering of pimples, Dr De Cruz says parents should look out for a change in skin texture.

“You might notice little bumps appearing that weren’t there before, plus discoloured or inflamed skin.

“We call these papules (red spots or blemishes), and that’s the sign that the immune system has come in and it’s starting to attack the oil glands that are working overtime,” he says.

Prepubescent acne is common on the face, but can also present across a child’s back, chest, shoulders and neck – all areas that have a higher density of oil glands.

“Most children will develop oily skin and then comedonal lesions (blackheads and blocked pores) in the T zone of the face,” Dr McDonald says.

“In most children, it will start on the face, commonly affecting the forehead and nose first.

“It can, however, affect other areas such as the chest and back, or progress to involve more of the face.”

How to treat prepubescent acne

With no miracle creams or quick-fix solutions, prepubescent acne treatment is about managing symptoms and preventing long-term scarring.

“When prepubescent acne is missed and it’s allowed to progress into full-blown teenage acne, or even acne that persists in the 20s and 30s, there’s a much higher risk of scarring,” Dr De Cruz says.

“We want to recognise it early and get the appropriate treatment at an earlier stage.”

From busting blackheads and whiteheads to treating painful nodes that grow under the skin, dermatologists can help keep things under control.

“Parents should seek help from a general practitioner or a specialist dermatologist with regards to prescription medications or creams if the problem persists,” Dr De Cruz says.

Meanwhile, Dr McDonald recommends that parents steer clear of harsh products and exfoliation, and opt for a gentle skincare routine instead.

“I would recommend, especially in younger children, to use very gentle products and to continue to protect the skin with SPF and moisturiser, which will help reduce inflammation,” she says.

Written by Hayley Hinze.