Hayashi et al classified the severity of facial acne using a simple grading scheme based on a global assessment. It can be used over time to evaluate the effectiveness of various treatment. The authors are from Tokyo Women's Medical University in Tokyo and Fujita Health University in Toyoake, Japan.

Lesions counted: inflammatory eruptions (papules and pustules)


Lesions are counted on each half of the face (left and right).


Number of Papules and Pustules on One Side of the Face


0 to 5


6 to 20


21 to 50


51 or more

very severe


The advantages of this approach:

(1) it is simple to perform

(2) it is reproducible between observers

(3) it is easy to teach using training photographs

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