Acne Across All Ages: Treating Pediatric, Adult, and Hormonal Acne

Acne is a common diagnosis for dermatology providers, yet its management can be surprisingly complex—both in distinguishing it from similar conditions and in tailoring treatment across diverse age groups. Julie Harper, MD, delivered a clear and practical talk on acne management from neonates to adults. She began by covering neonatal (0–6 weeks) and infantile acne (6 weeks–1 year), highlighting a key question: when is isotretinoin appropriate in young children? Dr Harper then addressed another challenging area: acne management during pregnancy and lactation. She walked through the timing and reintroduction of isotretinoin postpartum, and reviewed the risks associated with tetracyclines and spironolactone. To simplify safe prescribing, she shared a helpful mnemonic: “3 for 3 trimesters,” referring to three topical treatments (azelaic acid, benzoyl peroxide, clindamycin—ABC) and three antibiotics (amoxicillin [not in the first trimester], azithromycin, cephalexin, clindamycin, and erythromycin [not estolate, and not in the first trimester]—ACE). Finally, she turned to acne in non-pregnant, non-lactating adults, covering both established and emerging therapies. These included oral contraceptives, spironolactone, and clascoterone cream 1%, with thoughtful discussion of their benefits, drawbacks, and appropriate use.