Acne Grade I. The development of open comedones in an older teenager is a good prognosis. It means that their pores are handling the problem well and have a chance to mature, dilate, and develop into open comedones. However, if this is a younger teenager and the older brother has cystic acne it may be a sign of more severe acne to come.
Acne grade II. The most difficult type of acne to treat consists of myriad closed comedones that develop in acne grade II. There may be 300 such impacted pores on the face. They require a very irritating skin care program including glycol acid and vitamin A skin conditioners, and a thorough medical facial expert extractions.
Acne grade III. These are the inflammatory papules and pustules that occur in patients whose pores have poor resistance to acne. These pores break down rapidly before they develop into mature open and closed comedones. Small microcomedones break down rapidly and cause an intense inflammatory response, which may lead to scarring.
Acne Grade IV. When the lesions become larger, this s called nodular or cystic acne. The patient may have a background of grade I, II, III acne but then develop these types of cysts. These patients’ condition in more inflammatory, and they develop sever scarring. The key to recovery is a good skin care program, improvement of the acne, and the isotretinoin, if needed.