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Infantile cystic acne is rare, and its etiology is not clearly defined. Our patient had comedones at 2 months of age that were recalcitrant to multiple-antibiotic regimens. His condition worsened, and he was diagnosed with infantile cystic acne at 10 months of age and started on a trial of oral isotretinoin (Accutane). A five-month treatment period using doses ranging from 0.36 to 0.67 mg/kg was necessary to achieve adequate control. Oral isotretinoin may be safe and effective in cases of recalcitrant infantile acne, but we advocate close monitoring because of the well-known side effects of oral retinoids.
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