First Christian Church

Acne Grades

Dermatologists have developed a grading system in which all acne types are classified. Determining the grade of acne is done by simply visually inspecting the skin. There are specific criteria that are used to classify the symptoms of acne, including:

  • Presence of inflamed comedones
  • Presence of non-inflamed comedones
  • Breakout activity
  • Inflammation amount
  • Areas of the body that are affected

Knowing the grade of acne you are affected with is just as important as knowing the treatments for acne. Different grades of acne require different courses of treatment.

Grade I

This is the mildest form of acne. There might be some minor pimples present, but they are very small and only appear occasionally. Milia and blackheads are found, sometimes in very large amounts. However, there is no inflammation with Grade I acne.

This is typically seen in early adolescence. Adults can also experience it, with blackheads on the forehead and nose. Commonly, mili are found on the chin and in the eye area.

Grade I acne is easily treatable with OTC products containing salicylic acid and results are typically quickly evident. Making sure to take care to treat acne early on will keep it from getting worse, especially in teens. Grade I can possibly progress into Grade II if not treated.

Grade II

This is considered to be moderate acne. Both milia and blackheads are present, and usually in larger numbers. You will see more papules and pustules in Grade II. They will appear much more often and there is slight inflammation of the skin that is now visible.

With teens, you might see that the acne is progressing from the forehead and nose areas to other areas of the face. Acne could start appearing on the shoulders and chest, with occasional back acne. Adult women will find that they have more breakouts on their cheeks, jaw line, and chin, mostly right before and during their period.

Grade II is still easily treated at home with OTC products. Along with a product containing salicylic acid, you must also use a benzoyl peroxide lotion to kill the bacteria. However, if you do not see an improvement after a couple of weeks, you should seek treatment from a dermatologist. Grade II will progress to Grade III if the pimples are squeezed or constantly picked at.

Grade III

This is a severe form of acne. The biggest difference between Grade II and Grade III is the inflammation that is now present. It is obvious that the skin is now red and inflamed. Pustules and papules are now present in large numbers, and nodules are also present.

In addition to the face, Grade III acne affects the chest, upper back, neck, and shoulders. Because the infection is spreading and is deeper, the chance of scarring becomes much higher.

You should see a dermatologist if you have Grade III acne. It is typically treated with topical and systemic therapies that are only available through a prescription. If treatment is not sought, Grade III can easily become Grade IV.

Grade IV

This is by far the most serious of all acne. It is typically referred to as cystic or nodulocystic acne. Numerous cysts, pustules, and papules, and now, cysts, are present. There is a large amount of inflammation and breakouts tend to be much more severe. This form of acne is quite painful.

Grade IV acne usually affects other parts of the body besides the face, such as the chest, upper arms, shoulders, and entire back. The infection is very widespread and is prone to cause scars.

You must seek treatment from a dermatologist for Grade IV acne. It is very hard to control and requires powerful medications and topical treatments.