American Journal of Clinical Dermatology

, Volume 19, Issue 2, pp 139–144 | Cite as

Acne Scars: How Do We Grade Them?

  • Ashley K. Clark
  • Suzana Saric
  • Raja K. Sivamani
Current Opinion


Acne vulgaris is a chronic inflammatory skin disease that can lead to permanent scarring. Although grading scales exist for acne scarring, there are many limitations, and there is still a need for a well validated gold standard scale for use in clinical practice or research trials. An objective measure of scar severity should be a component of global acne severity evaluations. This manuscript reviews currently available acne scar grading modalities: lesion counting; subjective self-assessment; Acne Scar Rating Scale (ASRS); evaluator-based qualitative and quantitative scarring grading systems; Echelle d’Evaluation Clinique des Cicatrices d’acne (ECCA); Global Scale for Acne Scar Severity (SCAR-S); and imaging. Despite the varying tools, most of the currently available scales do not account for scar color, depth, or change over time. A new, validated scale is needed that would allow for a more objective and accurate assessment of scar progression over time to assist with effective treatment and research.


Compliance with Ethical Standards


AKC was supported by the National Center for Advancing Translational Sciences, National Institutes of Health (NIH), through grant number UL1 TR001860 and linked award TL1 TR001861. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Conflict of interest

RKS serves as a scientific advisor to Dermveda. AKC and SS have no conflicts of interest.


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Ashley K. Clark
    • 1
  • Suzana Saric
    • 1
  • Raja K. Sivamani
    • 2
    • 3
  1. 1.School of MedicineUniversity of California, DavisSacramentoUSA
  2. 2.Department of DermatologyUniversity of California, DavisSacramentoUSA
  3. 3.Department of Biological SciencesCalifornia State University, SacramentoSacramentoUSA

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