Questionnaire for acne prone skin includes all the questions related to acne which are answered by acne sufferers, whose response helps skin care manufactures to understand the problems and effects regarding acne to launch new and better acne products.
Questionnaire For Acne Prone Skin:
Fill your details:
Name: ________________
Gender: _______________
How old are you: ________________
Area/ district you live: ______________
Queries:
1. Which type of skin you have?
a) Normal b) dry c) oily d) any other ____________
2. Which type of pimple you have on your face?
a) oily b) dry c) any other ___________
3. Do you have acne on other parts of your body?
a) Yes b) no c) sometimes d) any other ______
4. What is the size of your acne?
a) Large b) small c) normal d) any other answer ____________
5. Do you have sebum secretion in your acne?
a) Yes b) no c) sometimes d) any other ______
6. Are you using any medicines for other health problems?
a) Yes
b) no
c) sometimes
d) any other ______
e) if yes, please mention your tablets _________
7. Do you have any tensions?
a) Yes b) no c) sometimes d) any other ______
8. How many times a day you will clean your face?
a) One time b) 2 times c) 3 times d) more than 3 times
9. Are you using any medicines for acne?
a. Yes
b. no
c. sometimes
d. if yes, please mention your tablets _________
10. What acne face products you are using to clean your face?
Specify your answer: ___________________
11. Are you applying any acne creams on your face?
a) Yes b) no c) sometimes d) if yes which cream_________
12. How many hours a day you sleep?
Specify your answer: _____________
13. Do you have a habit of sleeping during day time?
a) Yes b) no c) some times
14. Do you have a habit of drinking more water?
a) Yes b) no c) some times
15. Do you have a habit of eating fruits daily?
a) Yes b) no c) some times
16. Did you have a habit of pinching your acne?
a) Yes b) no c) some times
17. Did you consult your doctor for this problem?
a) Yes b) no
18. Did dermatologist or any other beauty expert recommend you to use any acne care products?
a) Yes b) no c) if yes which product ____________
19. Do you have spreading acne all over your skin
a) Yes b) no c) some times
20. Do you have redness in your pimples?
a) Yes b) no c) some times
21. Which pimples you have?
a) Red b) black c) any other _________
22. Do you have pain in your acne?
a) Yes b) no c) some times
23. Did you take any facial treatments in any salon for acne?
a) Yes b) no c) some times
24. From what age you are getting these pimples?
Specify your answer________ present age__________
25. Do you have any acne left sports?
a) Yes b) no c) some times
Questionnaire For Acne Prone Skin:
Fill your details:
Name: ________________
Gender: _______________
How old are you: ________________
Area/ district you live: ______________
Queries:
1. Which type of skin you have?
a) Normal b) dry c) oily d) any other ____________
2. Which type of pimple you have on your face?
a) oily b) dry c) any other ___________
3. Do you have acne on other parts of your body?
a) Yes b) no c) sometimes d) any other ______
4. What is the size of your acne?
a) Large b) small c) normal d) any other answer ____________
5. Do you have sebum secretion in your acne?
a) Yes b) no c) sometimes d) any other ______
6. Are you using any medicines for other health problems?
a) Yes
b) no
c) sometimes
d) any other ______
e) if yes, please mention your tablets _________
7. Do you have any tensions?
a) Yes b) no c) sometimes d) any other ______
8. How many times a day you will clean your face?
a) One time b) 2 times c) 3 times d) more than 3 times
9. Are you using any medicines for acne?
a. Yes
b. no
c. sometimes
d. if yes, please mention your tablets _________
10. What acne face products you are using to clean your face?
Specify your answer: ___________________
11. Are you applying any acne creams on your face?
a) Yes b) no c) sometimes d) if yes which cream_________
12. How many hours a day you sleep?
Specify your answer: _____________
13. Do you have a habit of sleeping during day time?
a) Yes b) no c) some times
14. Do you have a habit of drinking more water?
a) Yes b) no c) some times
15. Do you have a habit of eating fruits daily?
a) Yes b) no c) some times
16. Did you have a habit of pinching your acne?
a) Yes b) no c) some times
17. Did you consult your doctor for this problem?
a) Yes b) no
18. Did dermatologist or any other beauty expert recommend you to use any acne care products?
a) Yes b) no c) if yes which product ____________
19. Do you have spreading acne all over your skin
a) Yes b) no c) some times
20. Do you have redness in your pimples?
a) Yes b) no c) some times
21. Which pimples you have?
a) Red b) black c) any other _________
22. Do you have pain in your acne?
a) Yes b) no c) some times
23. Did you take any facial treatments in any salon for acne?
a) Yes b) no c) some times
24. From what age you are getting these pimples?
Specify your answer________ present age__________
25. Do you have any acne left sports?
a) Yes b) no c) some times
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