Acne — VA Disability Rating (DC 7828)

Diagnostic Code 7828 · 38 CFR §4.118

What Is It?

DC 7828 rates acne, and it draws one distinction that decides everything: deep versus superficial. Deep acne means inflamed nodules and pus-filled cysts — lesions that sit below the skin surface, hurt, and scar. Superficial acne means comedones, papules, pustules, and superficial cysts, and the schedule rates it at 0 percent no matter how extensive it is. So the first question in any acne claim is which kind is documented. Veterans develop or worsen acne in service for reasons the medical literature supports: occlusive helmets and body armor trapping heat and sweat, prolonged wear of protective gear, industrial oils and greases in maintenance work, field hygiene, and the well-documented effect of sustained stress on inflammatory skin disease. Chloracne from dioxin exposure is a separate condition with its own code at DC 7829 and its own Agent Orange presumption. The 30 percent ceiling on DC 7828 is low, but the code carries an explicit alternative: rate as disfigurement of the head, face, or neck under DC 7800 or as scars under DC 7801 through 7805, depending on the predominant disability — and for veterans with significant acne scarring, that is where the rating actually is.

Rating Criteria

Evidence Needed

The record needs to say deep. Dermatology notes describing nodulocystic acne, nodules, or cysts are what support a compensable rating, and notes describing comedones and pustules are not, so it is worth asking a treating dermatologist to characterize the lesions precisely. The percentage of the face and neck affected is the second number, and it is what separates 10 percent from 30 percent. Isotretinoin prescriptions are strong corroboration of severity, since the drug is reserved for severe nodulocystic disease. Service treatment records showing acne treatment in service are ideal; where they are absent, buddy statements about helmet and body-armor wear, MOS records for maintenance or mechanical work involving oils, and a nexus opinion do the work. For the scarring claim, dated photographs and measured areas of the face.

C&P Exam Tips

Ask the examiner to characterize the lesions as deep or superficial explicitly and to record the percentage of the face and neck affected — those two findings are the entire DC 7828 evaluation. Then ask for the second examination that matters more: have the DC 7800 characteristics of disfigurement completed for the scarring, measuring areas of abnormal texture, contour depression, and pigment change. Acne scarring frequently produces depressed scars over an area well beyond six square inches, and each qualifying characteristic counts under DC 7800. Do not schedule the exam right after a course of isotretinoin has cleared everything if you can avoid it, and bring photographs from an active period along with the full treatment history.

How to File

File on VA Form 21-526EZ as acne under DC 7828, and describe the in-service cause — helmet and body armor wear, protective gear, exposure to oils and greases, field conditions, sustained stress. In the same claim, separately claim facial scarring under DC 7800 as disfigurement of the head, face, or neck, since the code expressly contemplates that alternative and the scarring evaluation is usually the higher one. Attach dermatology records characterizing lesion depth, isotretinoin or antibiotic prescriptions, service records, and dated photographs. Claim any secondary depression or anxiety related to visible facial disease.

Common Mistakes

The first mistake is letting the record say superficial. Superficial acne of any extent rates 0 percent, so a note that describes papules and pustules where nodules and cysts are actually present costs the entire claim; ask the dermatologist to describe lesion depth specifically. The second mistake is stopping at DC 7828 and never claiming the scarring, when DC 7800 reaches 80 percent for disfigurement of the head, face, or neck and acne scarring frequently meets several of its characteristics. The third is filing chloracne under this code — chloracne has its own code at DC 7829 and is an Agent Orange presumptive condition, which is a materially different and easier claim. The fourth is being examined immediately after successful treatment with no photographs of the active disease.

Frequently Asked Questions

Why is my acne rated 0 percent?

Almost certainly because it was characterized as superficial. DC 7828 rates superficial acne — comedones, papules, pustules, and superficial cysts — at 0 percent regardless of how widespread it is. Only deep acne, meaning inflamed nodules and pus-filled cysts, is compensable. If your acne is genuinely nodulocystic, ask a dermatologist to document lesion depth in those terms and file for an increase.

How do I get more than 30 percent for acne?

Not through DC 7828, which caps at 30 percent. The route is the alternative the code itself names: rate as disfigurement of the head, face, or neck under DC 7800, which reaches 80 percent and scores eight characteristics of disfigurement including abnormal texture and depressed contour over areas exceeding six square inches. Acne scarring commonly meets several. Claim the scarring as its own issue and ask that the disfigurement characteristics be examined.

Is chloracne the same as acne under DC 7828?

No. Chloracne is rated separately under DC 7829 and is caused by dioxin exposure, which makes it an Agent Orange presumptive condition under 38 CFR §3.309(e) when it appears to a compensable degree within one year of herbicide exposure. If your history includes herbicide exposure, that is a far easier path to service connection than a direct acne claim, and the two should not be conflated.

Can military service cause adult acne?

It can cause it and it can worsen it, and both are compensable. Documented mechanisms include occlusion from helmets, body armor, and protective gear that traps heat and sweat against the skin, contact with industrial oils and greases in mechanical trades, field hygiene limitations, and the effect of sustained stress on inflammatory skin disease. Aggravation of preexisting acne is also compensable under 38 CFR §3.306.