Grading scale | Descriptive parameter | Categories of skin aging and photodamage | ||||||
Rhytides | Laxity | Elastosis | Dyschromia | Erythema telangiectasia | Keratoses | Texture | ||
0 | None | None | None | None | None | None | None | None |
1 | Mild | Wrinkles in motion, few, superficial | Localized to NL folds | Early, minimal yellow hue | Few (1-3) discrete small (<5 mm) lentigines | Pink E or few T, localized to single site | Few | Subtle irregularity |
1.5 | Mild | Wrinkles in motion, multiple, superficial | Localized, NL and early ML folds | Yellow hue or early, localized PO EB | Several (3-6), discrete small lentigines | Pink E or several T localized to 2 sites | Several | Mild irregularity in few areas |
2 | Moderate | Wrinkles at rest, few, localized, superficial | Localized, NL/ML folds, early jowels, early submental/SM | Yellow hue, localized PO EB | Multiple (7-10), small lentigines | Red E or multiple T localized to 2 sites | Multiple, small | Rough in few, localized sites |
2.5 | Moderate | Wrinkles at rest, multiple, localized, superficial | Localized, prominent NL/ML folds, jowels and SM | Yellow hue, PO and malar EB | Multiple, small and few large lentigines | Red E or multiple T, localized to 3 sites | Multiple, large | Rough in several localized areas |
3 | Advanced | Wrinkles at rest, multiple, forehead, PO and perioral sites, superficial | Prominent NL/ML folds, jowels and SM, early neck strands | Yellow hue, EB involving PO, malar, and other sites | Many (10-20) small and large lentigines | Violaceous E or many T, multiple sites | Many | Rough in multiple, localized sites |
3.5 | Advanced | Wrinkles at rest, multiple, generalized, superficial; few, deep | Deep NL/ML folds, prominent jowels and SM, prominent neck strands | Deep yellow hue, extensive EB with little uninvolved skin | Numerous (>20) or multiple large with little uninvolved skin | Violaceous E, numerous T, little uninvolved skin | Little uninvolved skin | Mostly rough, little uninvolved skin |
4 | Severe | Wrinkles throughout, numerous, extensively distributed, deep | Marked NL/ML folds, jowels and SM, neck redundancy and strands | Deep yellow hue, EB throughout, comedones | Numerous, extensive, no uninvolved skin | Deep, violaceous E, numerous T throughout | No uninvolved skin | Rough throughout |
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