• Lawrence F Eichenfield, Andrew C Krakowski, Caroline Piggott, James Del Rosso, Hilary Baldwin, Sheila Fallon Friedlander, Moise Levy, Anne Lucky, Anthony J Mancini, Seth J Orlow, Albert C Yan, Keith K Vaux, Guy Webster, Andrea L Zaenglein, Diane M Thiboutot, and American Acne and Rosacea Society.
• Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital, San Diego and Department of Pediatrics, University of California, San Diego, San Diego, California, USA. leichenfield@rchsd.org
• Pediatrics. 2013 May 1; 131 Suppl 3: S163-86.

IntroductionAcne vulgaris is one of the most common skin conditions in children and adolescents. The presentation, differential diagnosis, and association of acne with systemic pathology differs by age of presentation. Current acknowledged guidelines for the diagnosis and management of pediatric acne are lacking, and there are variations in management across the spectrum of primary and specialty care. The American Acne and Rosacea Society convened a panel of pediatric dermatologists, pediatricians, and dermatologists with expertise in acne to develop recommendations for the management of pediatric acne and evidence-based treatment algorithms.MethodsTen major topic areas in the diagnosis and treatment of pediatric acne were identified. A thorough literature search was performed and articles identified, reviewed, and assessed for evidence grading. Each topic area was assigned to 2 expert reviewers who developed and presented summaries and recommendations for critique and editing. Furthermore, the Strength of Recommendation Taxonomy, including ratings for the strength of recommendation for a body of evidence, was used throughout for the consensus recommendations for the evaluation and management of pediatric acne. Practical evidence-based treatment algorithms also were developed.ResultsRecommendations were put forth regarding the classification, diagnosis, evaluation, and management of pediatric acne, based on age and pubertal status. Treatment considerations include the use of over-the-counter products, topical benzoyl peroxide, topical retinoids, topical antibiotics, oral antibiotics, hormonal therapy, and isotretinoin. Simplified treatment algorithms and recommendations are presented in detail for adolescent, preadolescent, infantile, and neonatal acne. Other considerations, including psychosocial effects of acne, adherence to treatment regimens, and the role of diet and acne, also are discussed.ConclusionsThese expert recommendations by the American Acne and Rosacea Society as reviewed and endorsed by the American Academy of Pediatrics constitute the first detailed, evidence-based clinical guidelines for the management of pediatric acne including issues of special concern when treating pediatric patients.

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