In very mild forms of acne, little diagnosis is required. Most people who reach their teens will readily recognize the small blackheads or white pimples surrounded by a reddened area that constitute mild acne.

But more severe forms, where nodules or cysts form, where papule or pustules have spread around the face, shoulders and chest often call for a visit to the dermatologist. These skin professionals will obtain a complete history and carefully examine the affected areas. They’ll note the color, number and size of outbreaks.

The acne may consist of a field of small, white bumps called whiteheads. These will often disappear on their own. Blackheads form when the material reaches the surface, where it combines with air to form the characteristic dark color. These two are called, respectively, closed or open comedones. A good antibacterial cleanser and time may be all that’s needed.

In the more severe cases, where nodules or cysts form, the patient may have other symptoms we don’t commonly associate with acne, such as fever and aching joints, or even headaches and GI (gastrointestinal) distress. These indicate more serious types of acne, calling for more specialized treatments, such as prescription drugs or lasers.

When symptoms appeared, and in what order, is important. Typically, only the patient can provide that information. It’s useful to keep track by keeping a log. Note what type of lesion occurred before the appearance of any pustules and when.

Along the way the dermatologist will, naturally, attempt to rule out any alternative explanations.

Certain insect bites, such as mosquito or spider bites, can temporarily resemble acne. Mosquito bite lesions, left alone, will disappear in a day or two for all but those who are allergic. Spider bites are often harmless, but some may be poisonous and lesions can spread. That calls for entirely different treatment from acne.

Rosacea is a common skin disorder that differs from acne in several respects, but still forms papules and red pustules. Keratosis pilaris produces small bumps that may resemble whiteheads. Miliaria rubra, or heat rash, produces small red bumps. All of these would call for very different treatment from acne.

Similarly, many allergies can produce skin lesions, redness and many other symptoms similar to acne. Sexually transmitted diseases are a common ailment. Sometimes they actually produce acne, but they can cause other skin problems, too. Herpes, for example, may show up as red, painful bumps on the buttocks.

Certain drugs can actually cause acne. Anabolic steroids, lithium and prednisone, are common today. Phenobarbital and tetracycline can cause acne. Dermatologists will require a complete and honest history of drug use in order to make a proper diagnosis.

Sometimes, even excess use of Vitamin B complex can cause acne. The doctor will need to know about diet, supplements and whether any over the counter medications or remedies have already been tried.

Knowing as much as possible about your own skin and the history of any outbreaks will aid proper diagnosis. That, it should go without saying, is key to any proper treatment.

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