acne on the forehead of my nine year old daughter

my daughter has pimples on her forehead . is it normal for her age group. is it early puberty?

[loiloi]

Hi. My 9 year old son has had acne from a very early age. Our GP refered us to an endocrinologist for blood and urine tests to rule out an early puberty. It was discovered that he didn't have raised levels of androgens (male hormones found in both male and female bodies which stimulate the oil glands in the skin). But he is particularly sensitive to the effects of androgens (a common cause of acne).
We also saw a dermatologist who prescribed Differin (adapalene 0.1%) a topical synthetic retinoid. This should not be used on children under 12, except under medical supervision. It may be used on younger children if a doctor thinks that the potential side effects (dry skin, redness) are outweighed by the expected benefits (some clinical improvement in 4-8 weeks and further improvement with continued use).
Although benign in nature, acne can be devasting for the sufferer, and should be evaluated and treated as quickly as possible to avoid potential physical and psychological scarring.
An early puberty may be of more consequence to girls as it may result in early menstruation. Oral antibiotics can be used to treat acne in patients of 12 years and over (they must not be used prior to this as they can cause problems to teeth and bones which are still developing). Doctors may prescribe a combined oral contraceptive pill to female acne patients aged 13 or over. Although birth control is unecessary at this age, the pill blocks the actions of androgens which lead to acne. Taking the pill can also lessen other menstrual problems such as pain and heavy bleeding.
Eloise.