Clinical Score of Layton et al for Acne Scarring

Types of scars seen in association with acne:

(1) ice pick: deep or superficial scars with an irregular border, jagged edges, sharp margins and steep sides leading to a non-distensible fibrotic base.

(2) macular atrophic: soft distensible scars, with the base often wrinkled in the larger forms

(3) follicular macular atrophic: small, white perifollicular lesions, which may or may not be palpable above the skin surface.

(4) hypertrophic: less raised scars (as compared to keloidal scars) conforming to the area of the original acne insult

(5) keloid scars: raised, discrete indurated lesions extending beyond the boundaries of the initiating acne lesions

Scoring Post-Acne Scarring

score for ice pick, macular atrophic and follicular atrophic scars) =

= SUM(points for each of the 3 scar types present)

score for the hypertrophic and keloid scars) =

= (points for hypertrophic scars) + (points for keloid scars)

total score =

= (score for ice pick, macular atrophic and follicular atrophic types) + (score for hypertrophic and keloid scars)

Interpretation:

• minimum score: 0

• maximum score for ice pick, macular atrophic and follicular atrophic scars: 18

• maximum score for hypertrophic and keloid scars: 12

• maximum total score: 30

Conclusion:

• Early intervention is needed to minimize the severity of scarring seen  in patients with severe acne.