Accurate and reproducible acne assessment is a challenging task. While dozens of severity scales exist, most focus exclusively either on lesion counting or on evidence of scarring. An optimal grading system should ideally model how dermatologists are able to rapidly form an opinion on the acne state. By analyzing how dermatologists evaluate acne in the clinic, we first created a multidimensional acne severity space and then reduced it to a more intuitive scale that can be used for clinical and research use, linking acne’s visual features to a severity that reflects primary lesions as well as overall acne activity, and in particular scarring.
Create an acne grading system to provide, upon a visual inspection only of an acne affected skin area, a severity level that may serve as an entry point for treatment.
The electronic form below allows you to try out the multidimensional acne scale presented in the paper. Anyone can use it to assess acne from a visual inspection as long as they are familiar with the basic definitions of acne lesions and how they appear (here is a quick overview of primary lesions from the AAD). Please note that the scale should be used as explained in the manuscript and is only meant for a non-commercial use. We also ask that you cite the paper below if you use the scale for any research purposes.
Acne Guide: Causes, Acne Treatment, Acne Scarring And More
References: Bernardis E, Shou S, Barbieri, McMahon PJ, Perman, MJ, Rola LA, Streicher JL, Treat JR, Castelo-Soccio L, Yan AC, Development and Initial Validation of a Multidimensional Acne Global Grading System Integrating Primary Lesions and Secondary Changes, JAMA , Jan. 2020. [paper]
Acknowledgments: Thanks to the Penn Libraries' Biomedical Libraryand the Library's Innovation Intern, James Bigbee, for the implementation of the severity scale interface.
Dr. Bernardis obtained her PhD from the Computer and Information Science Department at Penn and also holds a M.E. in Computer and Information Science and an M.A. in Mathematics. Before joining the Penn faculty she was a Research Associate at the Children’s Hospital of Philadelphia.
Acne Vulgaris Complications
Tejas Mane finished his Master’s in Scientific Computing at Penn in 2020. He previously worked as a Junior Research Fellow at IIT Gandhinagar and graduated from BITS Pilani with an undergraduate degree in Mechanical Engineering.
Cameron is a second-year medical student with an interest in who is currently studying at the Perelman School of Medicine. He spent four years at the University of Chicago working towards his bachelor’s degree before graduating in 2020. His previous research projects have ranged from insect genetics to psychopharmacology before focusing on clinical dermatological imaging and alopecias here in the CoDe lab.
Natalia is a third year medical student at the Perelman School of Medicine interested in pursuing a career in , specifically skin of color. She received her undergraduate degree in neuroscience from the University of Pennsylvania.
Inflammatory Lesions In Acne
Navish Yarna is a Senior at the University of Pennsylvania, majoring in Biology. His research interests include Cell Biology, Computational , and Translational Research. Navish aspires to pursue a career in medicine in the future. Contact: nyarna@sas.upenn.edu
Aylar Bayramova has a B.S. in Biology with a Biomedical concentration from Arcadia University, where she also worked as a student researcher studying phylogeny of brown algae using molecular barcoding.
Shant Tanazian received his MD at Penn in 2021 and is now an intern at Massachusetts General Hospital. Before medical school, he studied Pharmacology and Toxicology at the University at Buffalo and he spent a year in Armenia volunteering as a medical clown in a children’s hospital and as an English teacher at the American University of Armenia and American Corner through the US Embassy.
Not All Acne Is Acne Vulgaris (25.04.2014)
Shahla is a second year undergraduate student at Haverford College with a prospective Chemistry major. She is interested in pursuing a career in . Her past research experiences involve biochemistry and computational chemistry work.Author: Reviewed and updated by Dr Amanda Oakley Dermatologist, Hamilton, New Zealand; Vanessa Ngan, Staff Writer; and Clare Morrison, Copy Writer; June 2014.Skin of colour update: Dr Chelsea Jones, Dermatology Research Fellow, The Skin Hospital Westmead NSW, Australia; Dr Monisha Gupta, Dermatologist, Conjoint University of NSW and Western Sydney University, Sydney, NSW, Australia. July 2021
Acne vulgaris is the common form of acne, characterised by a mixed eruption of inflammatory and non-inflammatory skin lesions (see all the acne types).
Nearly all of us have acne at some time or another. Acne affects both sexes and all races. Although acne mainly affects adolescents, it can affect a wide age range.
Nodular Acne: Treatment And Home Remedies
Acne most often affects the face, but it may spread to involve the neck, chest and back, and sometimes even more extensively over the body.
Individual lesions are centred on the pilosebaceous unit, ie the hair follicle and its associated oil gland. Several types of acne spots occur, often at the same time. They may be inflammatory papules, pustules and nodules; or non-inflamed comedones and pseudocysts.
Individual acne lesions usually last less than 2 weeks but the deeper papules and nodules may persist for months. Many acne patients also have oily skin (seborrhoea ).
Table 1 From Dermatological Tracking Of Chronic Acne Treatment Effectiveness
All characteristic lesions of acne vulgaris can occur in skin of colour, but it usually presents with less discernible redness and more postinflammatory hyperpigmentation (pigmented macules) which persists long after the acne lesion has gone. Post-inflammatory hyperpigmentation is often the major reason for seeking medical attention, causing significant psychological effects.
Pomade acne occurs more commonly in people with skin of colour due to cultural practices with hair styling products in African American and Hispanic populations. The use of greasy hair products leads to follicular plugging and comedones along the hairline.
Some dermatologists assess the severity of a patient's acne more precisely by using a grading scale. The inflammatory lesions are compared with a set of standard photographs to determine the grade, which may be 1 (very mild) to 12 (exceptionally severe) for example.
Extractions Vs. Oral Doxycycline For Acne Vulgaris
In clinical trials evaluating acne treatment, the numbers of non-inflamed and inflamed lesions are carefully counted at regular intervals. It is remarkably difficult to count consistently.
Treatment for acne depends on the patient's age and sex, the extent and the severity of the acne, how long it has been present, and response to previous treatments.
DermNet does not provide an online consultation service. If you have any concerns with your skin or its treatment, see a dermatologist for advice.
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