Proposal for a 4-type classification of acne: An evidence-based review of the literature

Background: Proper evidence-based classification and grading of a disease such as acne are important in guiding medical practitioners to properly diagnose diseases and treat patients. Objective: This is a review of the present classification of acne in order to delineate modified approaches of acne treatment. Methods: The available literature was reviewed, including searches from 7 databases based on the terms “classification of acne vulgaris and pathophysiology”, according to evidence-based medicine using the Cochrane risk of bias tool. Results: From a total of 10,121 studies on acne classification, 51 full-text articles were assessed and 13 studies were included after screening for acne classification. Conclusion: The European-evidence-based guideline (EDF) classification fits best. We propose a modified classification in 4 categories to improve the management of each stage of acne