Diagnosing Acne

How Acne is Diagnosed, Grades of Severity, and Common Acne Look-Alikes

Most people can easily self-diagnose mild acne, which can be treated at home using over-the-counter products. However, if you are unsure if what you are experiencing is acne, or if your acne seems severe, see your dermatologist. Acne is diagnosed by a simple visual inspection by your doctor. There is no test for acne.

Grades of Acne

When diagnosing acne, dermatologists classify it into four grades. They evaluate the types of comedones present, amount of inflammation present, breakout severity, how widespread the acne is and what areas of the body are affected.Grades of acne are classified as follows:

• Grade I - The mildest form of acne. The skin will displayblackheads, whiteheads or milia, and occasionally minor pimples. There is no inflammation. Grade I acne can usually be cleared with over-the-counter treatments.
• Grade II - Considered moderate acne. A greater number of blackheads and whiteheads are on the skin. Papules and pustulesare more frequently found. Grade II acne may also be treated with over-the-counter products. However, if there is no improvement after six to eight weeks, consult your doctor.
• Grade III - Moderate to severe acne. The difference between Grade II and Grade III acne is the amount of inflammation present. Papules and pustules will be more numerous and there will be a greater amount of redness and inflammation found on the skin. Nodules are often present. This type of acne should be evaluated by your dermatologist.
• Grade IV - The most severe grade of acne, the skin will display many pustules, nodules, and cysts. Blackheads and whiteheads are numerous. There is pronounced inflammation, and breakouts likely extend to areas other than the face. Grade IV acne, also called cystic acne, must be treated by a dermatologist.

Acne Look-Alikes

Some skin conditions can look remarkably similar to acne, although their causes and treatments are different. Do you have acne or an acne look-alike condition? If you are unsure, it is always wise to consult with a doctor. Common skin conditions that can be mistaken for acne include:

• Rosacea - Causes red, flushed skin with papules and pustules, especially in the nose and cheek area.
• Folliculitis - Bumps or pustules caused by inflammation of the hair follicle.
• Keratosis pilaris - Small, rough, "goose-flesh" like bumps most often found on the upper arms, thighs and buttocks, and sometimes the face.
• Miliaria rubra - Small red bumps on the surface of the skin caused by excessive heat exposure. Also known as heat rash.

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