Precocious puberty?

[mel11]

Hi, I have a 6year old daugher, and we have been dealing with Acne since she was 3. I have taken her to the pediatrician and to several dermatologists, and they really do nothing. About a year ago I took her to an Endocrinologist and she wanted my daughter to get blood tests done, because she was concerened. But, my daughter freaked out and wouldn't get the test. She has terrible Acne, very large and inflammed pimples on her forehead, and blackhead's on her chin. Also she gets them in her ears, and sometimes other places. It has been like this for 3 years now. And it's not getting better. AT ALL ! Could this be precocious puberty? Or something else?? She is very moody, cry's at the drop of the hat, for no reason. ( this is more than a normal kid, I have spoke to the pediatrician about this also ) I really don't know what to do, I am concerened for her. She is in 1st grade and sometimes doesn't want to go to school because of pimples, because she knows that her friends don't have them, it's really terrible. What do I do?? What kind of tests can be done?? What could this be?? Any help would be greatly appreciated :)

[kazzie29]

A related discussion, Teenage Acne was started.

[Deanna L Aftab Guy, MD]

Early acne in a 3 year old needs worked up!!! The sebaceous glands are now responding to what likely is an abnormal level of male hormones from the adrenal glands. We need to rule out something called congenital adrenal hyperplasia, yes a blood test is needed as well as what we call a stim test, they usually use freezy spray and place an iv so as not to have to poke her anymore, they get baseline labs and give a medicine and measure labs after that to see if the balance of steroid hormones made by the adrenals are made in an abnormal pattern, congenital  adrenal hyperplasia can present at birth but also can present later in the nonclassical cases with partial block, there is an enzyme block that prevents complete pathway progress in the steroid pathway production in the adrenals, therefore there is a build up of precursors like 17-OH progesterone or testosterone or dheas or androstenedione all of which can lead to increased body odor, acne, rapid growth, and virilization, in older girls even irregular periods.
So you are doing the right thing by seeing the peds endo and they can indeed work her up and provide treatment once the cause is found.
Ultimately they need to ultrasound the adrenal glands to be sure there is no mass lesion, unlikely if this has been 3 years long but necessary to complete the workup.

[mel11]

Thanks for your reply ! I made her an appt. with the Endo. for the 28th. We will get the blood work done no matter what it takes. I agree that this is not normal, and something could be wrong. What issues do u have with your daughter? I will keep u updated.
TY :)

[chellabob]

You absolutley need to have blood work done on your daughter!!!  When my girl was six yrs old it took 4 people to hold her down.  She is 10 now and still has a fit with bloodwork-not as bad but she is still a spaz when it comes to needles.  Please do this so you can find out what is wrong with your baby.Acne at her age is just not right.  Maybe she has a hormone imbalance.