{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T01:58:16Z","timestamp":1783735096599,"version":"3.55.0"},"reference-count":61,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:00:00Z","timestamp":1739750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82304040"],"award-info":[{"award-number":["82304040"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["202401AT070165"],"award-info":[{"award-number":["202401AT070165"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["JSSCBS20211610"],"award-info":[{"award-number":["JSSCBS20211610"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Acne scarring is a common consequence of acne vulgaris. Recently, there have been huge advancements in photoelectric therapies for scarring, leading to a growing body of literature on the efficacy and safety of these devices. However, interventional studies are hindered by the absence of standardized and validated outcome measures for acne scarring. In this article, we aim to review current grading modalities to assist clinicians in conducting acne scar research and therapies. PubMed and MEDLINE online databases were searched to identify acne scarring severity measurement tools. Each was classified into objective tools, subjective investigator-reported or patient-reported assessments and they were evaluated for reliability, sensitivity, validity and other important aspects. Objective instruments for assessing clinical efficacy in acne scarring show promise, especially PRIMOS, a three-dimensional imager with strong interrater reliability [intraclass correlation coefficient (ICC) &amp;gt; 0.90] and intrarater reliability (ICC &amp;gt; 0.96). Regarding subjective assessments, the \u00c9chelle d\u2019\u00c9valuation Clinique des Cicatrices d\u2019Acn\u00e9 (ECCA) tool features the widest range of applications and shows acceptable performance. The original ECCA tool scored five out of eight points, while the adapted version achieved six out of eight points after combining three essential factors: reliability, sensitivity and validity. The Goodman and Baron Global Acne Scarring Grading System (GSGS) score also achieved a good score of seven out of eight. However, most scales demonstrated poor or moderate performance owing to the lack of reliability testing and evidence from independent assessment. Our conclusion is that PRIMOS stands out as a strong objective tool, whereas GSGS and adapted ECCA are the leading subjective scales with acceptable to strong performance. More importantly, there is the need for standardized scales, facilitating the pooling of results for systematic reviews, meta-analyses and clinical recommendations.<\/jats:p>","DOI":"10.1093\/ced\/llae550","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T03:05:47Z","timestamp":1739761547000},"page":"1496-1507","source":"Crossref","is-referenced-by-count":4,"title":["Choosing the right outcome measures for acne scar research: a guide for clinicians"],"prefix":"10.1093","volume":"50","author":[{"given":"Xin","family":"Zhang","sequence":"first","affiliation":[{"name":"Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College , Nanjing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Xie","sequence":"additional","affiliation":[{"name":"Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College , Nanjing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College , Nanjing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzhen","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, The Affiliated Jiangning Hospital with Nanjing Medical University , Nanjing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3196-5406","authenticated-orcid":false,"given":"Rong","family":"Zeng","sequence":"additional","affiliation":[{"name":"Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College , Nanjing ,","place":["China"]},{"name":"Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs , Nanjing ,","place":["China"]},{"name":"Department of Dermatology, Yunnan Provincial Hospital of Traditional Chinese Medicine , Kunming ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,2,17]]},"reference":[{"key":"2025072412174659600_llae550-B1","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1111\/ijd.15280","article-title":"The prevalence, risk factors, and psychosocial impacts of acne vulgaris in medical students: a literature review","volume":"60","author":"Sachdeva","year":"2021","journal-title":"Int J Dermatol"},{"key":"2025072412174659600_llae550-B2","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1590\/S0365-05962012000600007","article-title":"The impact of acne vulgaris on quality of life and psychic health in young adolescents in Greece. Results of a population survey","volume":"87","author":"Tasoula","year":"2012","journal-title":"An Bras Dermatol"},{"key":"2025072412174659600_llae550-B3","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1111\/jocd.12558","article-title":"Tumor necrosis factor alpha-308 G\/A and interleukin 1 beta-511 C\/T gene polymorphisms in patients with scarring acne","volume":"18","author":"Akoglu","year":"2019","journal-title":"J Cosmet Dermatol"},{"key":"2025072412174659600_llae550-B4","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1111\/bjd.17851","article-title":"Atrophic acne scar: a process from altered metabolism of elastic fibres and collagen fibres based on transforming growth factor-beta1 signalling","volume":"181","author":"Moon","year":"2019","journal-title":"Br J Dermatol"},{"key":"2025072412174659600_llae550-B5","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/j.1365-2133.2004.05749.x","article-title":"Inflammation in acne scarring: a comparison of the responses in lesions from patients prone and not prone to scar","volume":"150","author":"Holland","year":"2004","journal-title":"Br J Dermatol"},{"key":"2025072412174659600_llae550-B6","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1097\/DSS.0000000000003397","article-title":"Review of lasers and energy-based devices for skin rejuvenation and scar treatment with histologic correlations","volume":"48","author":"Chen","year":"2022","journal-title":"Dermatol Surg"},{"key":"2025072412174659600_llae550-B7","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1159\/000328236","article-title":"Laser principles","volume":"42","author":"Bogdan Allemann","year":"2011","journal-title":"Curr Probl Dermatol"},{"key":"2025072412174659600_llae550-B8","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1111\/jocd.12775","article-title":"In vivo dynamic thermal imaging of skin radiofrequency treatment","volume":"18","author":"Wilczynski","year":"2019","journal-title":"J Cosmet 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