There are many different types of acne. To help treat and understand the condition, Dermatologists classify the different types of acne into four grades, simply known as Grade I; Grade II; Grade III; and Grade IV.
Understanding the grade of your acne can help you, or your doctor choose the course of treatment that will be most effective. It’s the best way to determine what products you should be using for the most effective treatment and it can also help you decide if you can treat your acne at home or if you should see your dermatologist.
Determining acne grade is done by a simple visual inspection of the skin. Specific criteria are used to classify acne symptoms, including:
- types of non-inflamed comedones (blackheads and whiteheads) present
- types of inflamed comedones (papules, pustules or cysts) present
- amount of breakout activity
- amount of inflammation, if any
- areas of the body affected by acne
Grade I: This is the mildest form of acne. There may be one or two minor pimples but they will small and will appear only very occasionally. Blackheads and whiteheads are present but there is no inflammation or irritation associated with Grade I acne.
Grade I acne is most common in teenagers, although adults are not immune to this type of acne. Grade I acne appears mostly on the nose and/or forehead. Whiteheads associated with Grade I acne are commonly found around the eye area and chin.
This type of acne can be successfully treated at home using an over-the-counter product containing salicylic acid and adhering to a good cleansing routine. Results generally are seen quickly. Treating acne while it is still in its early stages helps prevent acne from progressing, especially in teens. Grade I acne may progress to Grade II if left untreated.
Grade II: This is classified as moderate acne. You now have many more blackheads and whiteheads and will start seeing more papules and the formation of pustules (pimples). The skin will also begin to look slightly inflamed.
In teenagers, Grade II acne now begins to progress from the nose and forehead to other areas of the face. Women will tend to breakout around the cheeks, chin and jaw line, and males may begin to show signs of acne on the chest, shoulders and back.
You can treat Grade II acne at home with over-the-counter products that contain salicylic acid and a benzoyl peroxide lotion to help kill the bacteria and prevent inflammation. Avoid harsh scrubs like those that contain apricot seeds, since these can scratch and damage the skin. There is a much higher risk of scarring, so picking the skin and popping pimples is NOT a good idea! A strict cleansing regimen is necessary and clean clothing, bed linens and face towels will help prevent the condition from worsening. If home remedies and treatments do not improve or control the condition, it might be best to visit a dermatologist for a professional opinion and/or treatment options.
Grade III: This type of acne is considered severe. Papules and pustules have developed in greater numbers, and nodules will be present. The main difference between Grade II acne and Grade III is the amount of inflammation present. The skin is now obviously reddened and inflamed. Grade III usually involves other body areas, such as the neck, chest, shoulders, and/or upper back, as well as the face. The chance of scarring becomes higher as the infection spreads and becomes deeper.
Grade III acne should be treated by a dermatologist who will probably use prescription grade topical and systemic remedies to control the acne. The daily cleansing routine, and keeping everything the skin touches clean is still important. While Grade III acne is severe, it is quite common, but can be confused with Grade IV acne.
Grade IV: This is the most severe type of acne and is generally very rare. Most people take measures to control the condition before it can progress to Grade IV. At this point there is evidence of an extreme amount of papules and deeper cystic and nodular lesions. For that reason it is commonly referred to as nodularcystic or cyctic acne and is very painful.
Grade IV acne usually extends beyond the face, and may include the back, chest, shoulders, and upper arms. The infection is deep and widespread. Nearly all cystic acne sufferers develop permanent scarring.
Grade IV acne is difficult to control and must be treated by a dermatologist who will use the most powerful systemic medications and topical treatment available.
For more information on acne, how it forms, how to treat it, do’s and dont’s, acne scars and more, read the related articles below.
- Frequently Asked Questions About Acne
- Treating Mild to Moderate Acne Scars
- Acne Fighting Foods
- Acne Laser Treatment: Is it Effective?
- Acne Scars
- Adult Acne – It’s more common than you think
- The Basics of Treating Back Acne
- Treating Mild Acne at Home
- Home Remedies for Acne