Hi there,
Grading scales are used to grade the severity of acne and these can be in the form of pictorial scales, location of acne, number of acne lesions and type of acne lesions.
Using a combination of both and from your photo, the entire area is affected with the addition of nodules and cysts. This does put you in the severe category and should seek treatment asap so as to help prevent subsequent scarring as mentioned by Dr Chin.
Hope that helps.
All the best!
