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Review
. 2024 Apr;36(2):65-73.
doi: 10.5021/ad.23.094.

A Comprehensive Review of the Acne Grading Scale in 2023

In Ho Bae  1 , Jun Ho Kwak  1 , Chan Ho Na  1 , Min Sung Kim  1 , Bong Seok Shin  1 , Hoon Choi  2
Affiliations
Review

A Comprehensive Review of the Acne Grading Scale in 2023

In Ho Bae et al. Ann Dermatol. 2024 Apr.

Abstract

Acne is a common skin inflammatory condition that can significantly affect the patient's quality of life. Therefore, accurate assessment scales are very important for treatment and management of acne vulgaris. This review article issues a comprehensive review of various acne severity assessment scales. In this text, the authors review the acne grading scales, such as the Pillsbury scale, Cook's acne grading scale, Leeds acne grading system, Global Acne Grading System, and investigator's global assessment, etc. And we delve into the characteristics, advantages, limitations, and applicability of these scales. The acne grading scale to be developed in the future should be objective, accurate, comprehensive, easy to use, and applicable in a variety of clinics and research settings. Current technologies, such as artificial intelligence, could potentially contribute to the development of ideal acne grading scales that meet unmet needs.

Keywords: Acne; Assessment; Grading; Scale; Severity.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1. Proposed 9-point multidimensional acne global grading system.
Primary lesions and secondary changes can be encoded into a score by first counting lesions (nodules, papules/pustules, and comedones), choosing the highest corresponding row, and then selecting the degree of secondary changes (and choosing the correct combination). The dashed lines indicate any possible entry (i.e, the final severity is independent of that specific feature/variable). Scars and inflammation should be categorized as none, mild/moderate, or severe. And post-inflammatory refers to any post-inflammatory color change (eg. focal color changes and/or diffuse erythema not associated with primary acne lesion activity, hyperpigmentation, redness, dryness, or color change due to treatment) and should be marked Yes. *For nodule, few; 2 to 3, some; 4 to 6, and many; more than 6; †For papules/pustules, few; 1 to 3, some; 4 to 8, and many; more than 8; ‡For comedones, few; 1 to 3, some; 4 to 12, many; more than 12; §Mild +, differentiation of severe comedonal acne.
See this image and copyright information in PMC

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