| 1 | Macular Disease | Erythematous, hyper-or hypopigmented flat marks visible to patient or observer irrespective of distance | Erythematous, hyper-or hyphopigemented flat marks |
| 2 | Mild Disease | Mild atrophy or hypertrophy that may not be obvious at social distances of 50 cm or greater and may be covered adequately by makeup or the normal shadow of shaved beard hair in males or normal body hair if extrafacial | Mild rolling, small soft papular |
| 3 | Moderate Disease | Moderate atrophic or hypertrophic scarring that is obvious at social distance of 50 cm or greater and is not covered easily by makeup or the normal shadow of shaved beard hair if extrafacial, but is still able to be flattened by manual stretching of the skin. | More significant rolling, shallow “boxcar”, mild to moderate hypertrophic or papular scars |
| 4 | Severe Disease | Severe atrophic or hypertrophic scarring that is obvious at social distances of 50 cm or greater and is not covered easily by makeup or the normal shadow of shaved beard hair in males or normal body hair if extrafacial and is not able to be flattened by manual stretching of the skin. | Punched out atrophic (deep “box car”), “ice pick”, bridges and tunnels, gross atrophy, dystrophic scars significant hypertrophy or keloid |