Postacne Scarring: A Qualitative Global Scarring Grading System

BACKGROUND There is no global qualitative grading system for assessing the disease load and global severity of disease in a patient with postacne scarring. OBJECTIVE The purpose of this article is to provide a simple qualitative grading system that would allow better communication between practitioners of a patient's global disease severity and the most appropriate corresponding therapy for that degree of acne scarring. METHODS Four grades of postacne scarring are described, and appropriate therapeutic interventions are presented for each. Grade assignment is made by lesion morphologies and disease load as indicated by patient perception of severity (i.e., whether or not an individual can easily disguise his or her disease at social distances). RESULTS A simple qualitative global acne scarring grading system is presented. LIMITATIONS The determination of disease load in terms of patient perception of severity is intrinsically imperfect due to varying subjectivity among individuals. CONCLUSION A global acne scarring grading system is presented that is simple to use and may optimize therapeutic intervention. This system would also allow investigators, educators, and proceduralists to compare their cases more accurately and to have a more objective discussion of the efficacy of operative interventions or therapies.