Grade 1 acne. This is the mildest grade of Acne. Grade 1 acne consists primarily of blackheads and whiteheads that suffer no inflammation or reddening and are most often seen in adolescents in the nose and forehead. Grade 1 acne consists of: 1. minimal blackheads 2. A few papules (red pimples) Grade 2 acne.Moderate acne. Blackheads and whiteheads can break out in greater numbers. They can come in larger papules with some appearing as large pustules with slight inflammation getting obvious. The outbreaks now appear on the cheeks, chin and jaw in addition to the nose and foreheads. Grade 2 acne consists of: 1. Blackheads 2. Milia 3. Inflammation 4. Redness 5. Papules 6. Pustules Grade 3 acne. Considered severe and is often Grade 2 left untreated and made to worsen by squeezing the pimples and maintaining the oily dirty face that attracted those bacteria at the onset. The main difference now is the level of inflammation with the skin suffering Grade 3 acne exhibiting more profuse reddening and a greater number of inflamed papules and pustules. This is the grade when infection spreads and becomes deeper and the risk of scarring gets highest. Grade 3 acne consists of: 1. Blackheads 2. Inflammation 3. Redness 4. Papules 5. Pustules Grade 4 acne. Grade 4 acne is the most serious and is normally Grade III left untreated. The condition is medically referred to as nodulocystic or cystic acne where the skin displays numerous pustules, papules, pustules, with large cysts. There is severe inflammation and pain as cystic acne is very painful. Often the infection spreads beyond the face and into the neck, shoulders, back, chest and upper arms. The deep infection makes scarring inevitable and may even require cosmetic surgery after to restore a decent looking skin. Grade 4 acne consists of: 1. Extreme amount of sore Pustules 2. More than papules. 3. Extreme Edema

Acne is a skin condition characterised by the appearance of whiteheads, spots and blackheads. They can be sore and painful as well as being unsightly. They are most commonly located on the face, but may also appear on the chest and the back. Acne affects young adults of either sex. While it is occasionally seen in young children or mature adults, it is most common between the ages of 17 and 23. There is a great deal of individual variation in the age at which acne starts, its severity, and its duration; generally, the condition improves through the mid to late twenties, although in some people, acne may persist well into adulthood.

Acne is the result of a change in the activities of the sebaceous (oil producing) glands in the skin. Human skin is divided into two layers; a thin, outer layer called the epidermis, and a deeper layer called the dermis. The dermis is much thicker than the outer epidermis and contains all of the nerves and blood vessels that the skin requires. The dermis also contains the hair roots (‘follicles’). Associated with each hair root is a sebaceous gland. The oily liquid that the sebaceous glands produce is called sebum, which passes out of the follicle to the outer surface of the skin. Here it functions to lubricate the skin and keep it flexible. The classic symptoms of acne are the result of an overproduction of sebum by the sebaceous glands, which often starts around the time of puberty. As the body starts the transition from child to adult, the levels of certain hormones in the blood rises. Whilst there are many hormones in the body, the hormones that are thought to be involved in the development of acne are androgens – masculinising hormones which are present both in men and women. Sebaceous glands are very sensitive to androgens, and respond by producing more sebum; the glands also increase in size. When the sebum reaches the surface of the skin, it reacts with the atmosphere and becomes thicker. With the exit from the follicle now partly obstructed by the thickened sebum, the flow from the gland slows down; bacteria from the skin can then infect the stagnating sebum left in the gland. As the sebaceous glands are often enlarged, sebum can escape from the gland into the surrounding dermis where it causes localised irritation and inflammation. Whiteheads or blackheads (‘comedones’) are seen when the opening from the hair follicle finally becomes blocked by the thickened sebum, skin bacteria and cellular debris from inside the follicle. Red, inflamed spots may be seen and are probably the result of the leaking sebum irritating the dermis. Sometimes small pus-filled blisters develop in the inflamed spot. These usually settle down in a few days. The dark tip of a blackhead is caused by an accumulation of melanin, a natural skin pigment. While these symptoms are mostly seen in teenagers, they can occasionally be seen in mature adults as well. Women make up the majority of these mature cases; here the acne may be due to an increased sensitivity to androgens.