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Updated: Feb 23, 2026

Visualizing Scar Development Using SCAD Assay - An Ex-situ Skin Scarring Assay
Published on: April 28, 2022
Acne Scars: How Do We Grade Them?
Ashley K Clark1, Suzana Saric1, Raja K Sivamani2,3
1School of Medicine, University of California, Davis, Sacramento, CA, USA.
Abstract:
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.
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