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Understanding different types of acne

Tried every acne prescription under the sun, yet your acne won’t go away?

Did you know dermatologists classify acne into five grades?

A useful tool that helps you evaluate the level of acne in your skin and how to treat it

The types of acne

Grade One

This is the mildest form, most common in adolescents, but some adults suffer from this acne.

  • blackheads and whiteheads are often found around the T zone, chin, and forehead
  • milia may be present on the eyelids or under the eyes and cheeks
  • there may be a few minor pimples on the chin or cheeks
  • at this stage, there is no inflammation, and only a few papules or pustules present

Bacteria, dead cells, and oil build-up at the root of the hair follicle; P. acnes bacteria love this environment and multiply, which causes inflammation and redness in the pore.

Getting your acne under control at this stage is essential; this is why a suitable treatment plan is key, which will help prevent pimples from turning into painful cysts and eliminate any chances of scarring.

Grade Two

This grade of acne can spread to the chest, back, and shoulders.

  • the T zone and forehead are most commonly affected
  • blackheads, whiteheads, and milia are present
  • some acne breakouts may be visible in the form of raised inflamed bumps
  • slight inflammation in the skin is apparent, along with some light superficial scarring

Grade Three

What differentiates this type of acne from grade two is the skin’s inflammation level.

  • grade three acne is quite severe; it often looks angry and inflamed
  • at this stage, the texture of the skin has become uneven and dull, although not overly oily
  • inflamed papules are also present, as well as acne lesions referred to as pustules
  • These appear throughout the T zone, spreading out onto the cheeks. Other areas of the body also affected are the chest, neck, back, and shoulders

Grade Four

This is often referred to as hormonal acne.

  • this grade of acne is found around the lower part of the face, particularly along the chin, jaw, and neck
  • as with grade three, it is also found on the body
  • breakouts appear as flat-crusted lesions
  • at this stage, papules are red, inflamed and tender
  • nodules appear under the skin
  • the skin becomes sensitised, inflamed and scarring is apparent
  • this grade needs to be treated with extreme care to prevent possible scarring and re-infection

Grade Five

This is the cause of cystic acne and is the most severe form.

  • the skin is very coarse and uneven
  • blackheads and comedones are replaced by fluid-filled lumps, which are located under the skin’s surface and gives the skin its uneven appearance
  • pitting is evident with this grade due to deep scarring
  • this type of acne can be excruciating
  • when treating this grade of acne, some do suffer psychologically, so they need to be treated with extreme care

With grades four and five, the chances of scarring are high; this is why we refer our clients to a dermatologist; who is qualified to treat this more severe grade of acne.

If you are concerned about your skin, we advise making an appointment with a dermatologist; they will thoroughly assess your skin and accurately determine the acne classification for your particular skin condition.

So you can treat it correctly, with minimum risk of infection and scarring.


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