Acne Grading Scale: Knowing Your Acne Type

Table of Contents

Acne Severity Scale

Acne Grading

There are more than 25 acne grading systems used in the world today. However, there is no common consensus on which one to use. Acne grading depends on the type of the lesion (papules, pustules, comedomes, nodules and/or cyst), the number of lesions and the surface area involved. Even so, the different grading system can be tedious and subjective as they may involve counting individual acne lesions or comparison using photographs.

Why Do We Need To Grade Acne?

Acne grading is the first step to guide proper and successful treatment. Individuals with mild acne will largely benefit from topical acne therapy, whereas those with more severe grades of acne will benefit from oral therapy.

Furthermore, it has been shown that patient's perception of their acne severity may differ from clinical assessment. If you perceive your acne to be mild when you are in fact suffering from severe acne, you may delay treatment and risk acne scarring.

Mild Acne
Mild Acne
Moderate Acne
Moderate Acne
cystic acne
Severe Acne

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What Are The Common Acne Grading Systems?

The most commonly Acne grading tools used today are:

  • Investigatory's global assessment (IGA) 
  • Global Acne Severity Scale (GEA)
  • Comprehensive Acne Severity Scale (CASS)

The grading systems takes into account the type of acne lesions:

  • Non-inflammatory leisons (whitehead and blackheads)
  • Inflammatory lesions (papules and pustules)
  • Nodulo-cystic leions

Taking into account the type and quantity of the acne lesion, a grade is given, using a numeric scale. For example, 0-Clear to 5 Very-Severe. 

Global Acne Severity Scale (GEA)

Grade Value Description
Clear O Clear. Residual pigmentation and redness
Almost Clear 1 A few scattered open and closed comedomes. A few papules.
Mild 2 Less than half the face involved. A few open and closed comedomes. Also a few papules and pustules.
Moderate 3 More than half the face is involved. Numerous open, closed comedomes, papules and pustules. One nodule may be present,
Severe 4 Inflammatory acne. Numerous open, closed comedomes, papules and pustules. Few nodules and cysts.
Very Severe 5 Highly inflammatory acne covering the affected areas. Many nodules and cysts present.

The Future of Acne Grading?

While no acne grading system is perfect (which is why there are more than 25 different ones), computational analysis based on imaging may reduce the subjectivity and improve uniformity to help guide treatment. Incorporating artificial intelligence in diagnosis will lead to more accurate diagnosis and more effective acne treatments.

About Dr Moses Ng

MBBS (London) with distinction
Dip Practical Dermatology (Cardiff) with distinction
Member of American Acne & Rosacea Society
Fellow of American Society for Laser Medicine & Surgery

Dr. Moses Ng is a distinguished professional in the field of aesthetic medicine, renowned for his expertise in advanced cosmetic procedures. With over 15 years of experience, extensive training and a keen eye for detail, Dr. Ng specializes in a wide range of treatments, including injectables, laser therapies, and acne scar management.

Dr. Moses Ng’s commitment to excellence and patient-centric approach have earned him a reputation as a trusted clinician in aesthetic medicine. His continuous pursuit of the latest advancements in the field ensures that his patients receive the highest standard of care and the most effective treatments available.

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