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AAFP: Grading System Helps When Treating Acne By Mike Fillon NEW ORLEANS, LA -- October 15, 2003 -- Most family physicians know how to diagnose acne; but with so many treatments on the market, how to treat it is a different issue. Kristin S. Tate, MD, discussed her Acne Grading System during a lecture here on October 5th at the American Academy of Family Physicians 55th Annual Scientific Assembly. Dr. Tate, a dermatologist from Boone, North Carolina, United States, devised her grading system while writing a book entitled Well Managed Dermatology. She gives acne a score of 1 to 4 depending on severity. The grading is based primarily on the degree of inflammation and the depth of lesions. She said this helps doctors determine whether a benzoyl peroxide might be good enough for mild cases. At the other end of the scale, if a patient has significant scarring, she said, doctors should not prescribe the retinoids and go ahead and recommend isotretinoin (Accutane). "You start with certain medications, and if they don't work you step it up to the next level." Dr. Tate added, however that doctors should be cautious when prescribing isotretinoin, since there are potentially dangerous side effects, including birth defects when an expectant mother uses it while pregnant. Preaching patience to patients is also important, since it takes 4 to 6 weeks after treatment begins before there is improvement. "It's important that you tell your patients there is no quick fix," said Dr. Tate. "They aren't going to just leave your office and put the gel on their face and their acne is gone." At the same time, Dr. Tate recommended that doctors be sympathetic, and not minimize the impact acne might be having, especially when a patient is a youngster. "Teenagers can be very cruel," said Dr. Tate. "Recognize their distress, and reassure them there are ways to treat it." [Study title: "Grading Acne: An Approach to Diagnosis and Treatment". Abstract 015] E-mail this page to a friend or colleague! To print, use this version