Follow-up acne questionnaire

First and last name *

I wish to participate via *

Online chat
Phone call

Online chat is located in patsient.ee portal where you have to log in with Estonian mobile ID or ID card. When you choose phone call, doctor will call you during previously scheduled time.

How many weeks have passed since the last visit? *

How bad is you acne currently?

Valitud number: 0

0 - clear skin 1 - few comedones and papules; 2 - comedones, papules and pustules; 3 - many comedones, papules, pustules and also one deeper nodule 4 - lots of comedones, papules, pustules and nodules 5 - very inflammatory acne, lots of hard and painful cysts, nodules, pustules and papules

Give yourself an evaluation, how good have you been keeping up with the treatment regime

Valitud number: 1

1 - have not used prescribed treatment; 3 - have used drugs sometimes; 5 - have used drugs as prescribed by the doctor

Name the treatment drugs and creams you are currently using *

Have you experienced any side effects from prescribed drugs? *

How do you rate your current treatment results? *

Additional information you would like to add:

Are you currently pregnant, do you wish to get pregnant currently or are you breastfeeding?

* answer this question if you are a woman

Upload photos *

Click or drag files to this area to upload. You can upload up to 10 files.

Photos with a good quality are necessary to prescribe the best treatment plan for your skin. Do get the best photos, follow these simple rules: make your photos in a well lit room, best light is natural sunlight; photo background should be neutral in colour (for example a white coloured wall); do not use flash while taking photos; make photos without any makeup; make sure that the skin is in focus and the photo is not blurry; Take photos on the left side, right side and from the front of your face. In addition when take close up photo from the most problematic region. If you have any body acne, take photos from the back or the chest area also.