<unk>  vulgaris is diagnosed based on a medical professional's clinical judgment. The evaluation of a person with suspected<unk>  should include taking a detailed medical history about a family history of<unk> , a review of medications taken, signs or symptoms of excessive production of androgen hormones, cortisol, and growth hormone. Comedones (blackheads and whiteheads) must be present to diagnose<unk> . In their absence, an appearance similar to that of<unk>  would suggest a different skin disorder. Microcomedones (the precursor to blackheads and whiteheads) are not visible to the naked eye when inspecting the skin and require a microscope to be seen. Many features may indicate that a person's<unk>  vulgaris is sensitive to hormonal influences. Historical and physical clues that may suggest hormone-sensitive<unk>  include onset between ages 20 and 30; worsening the week before a woman's period;<unk>  lesions predominantly over the jawline and chin; and inflammatory/nodular<unk>  lesions. Several scales exist to grade the severity of<unk>  vulgaris, but disagreement persists about the ideal one for diagnostic use. Cook's<unk>  grading scale uses photographs to grade severity from 0 to 8, with higher numbers representing more severe<unk> . This scale was the first to use a standardized photographic protocol to assess<unk>  severity; since its creation in 1979, the scale has undergone several revisions. The Leeds<unk>  grading technique counts<unk>  lesions on the face, back, and chest and categorizes them as inflammatory or non-inflammatory. Leeds scores range from 0 (least severe) to 10 (most severe) though modified scales have a maximum score of 12. The Pillsbury<unk>  grading scale classifies the severity of the<unk>  from grade 1 (least severe) to grade 4 (most severe). Differential diagnosis Many skin conditions can mimic<unk>  vulgaris, and these are collectively known as<unk> iform eruptions. Such conditions include angiofibromas, epidermal cysts, flat warts, folliculitis, keratosis pilaris, milia, perioral dermatitis, and rosacea, among others. Age is one factor that may help distinguish between these disorders. Skin disorders such as perioral dermatitis and keratosis pilaris can appear similar to<unk>  but tend to occur more frequently in childhood. Rosacea tends to occur more frequently in older adults. Facial redness triggered by heat or the consumption of alcohol or spicy food is also more suggestive of rosacea. The presence of comedones helps health professionals differentiate<unk>  from skin disorders that are similar in appearance. Chloracne and occupational<unk>  due to exposure to certain chemicals & industrial compounds, may look very similar to<unk>  vulgaris.
Acne
Hidradenitis suppurativa
Oscar 
Miliaria
Sunburn
Rosacea
Scar
Folliculitis