Proposal for a 4-type Classification of Acne: An Evidence-Based Review of the Literature

O. Prapapan2, *, C. C. Chatchavarn2, P. Suvanprakorn2, H. A. M. Neumann1, R. Knobler3, A. Prombandankul2, K. Siriapaipun2
1 Department of Dermatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
2 Panrajdhevee Group, Bangkok, Thailand
3 Department of Dermatology, University of Vienna, Vienna, Austria

© 2020 Prapapan et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Panrajdhevee Group, Bangkok, Thailand; Tel: 662 2540314; Email:



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.


This is a review of the present classification of acne in order to delineate modified approaches of acne treatment.


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.


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.


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.

Keywords: Classification, Acne, Toll-like receptor, Literature, Evidence, Dermatology.