# VL-AcneSeg: A Vision-Language Framework for Region-Aware Acne Lesion Segmentation

arXiv: https://arxiv.org/abs/2609.34472 · HTML: https://mlsanity.com/paper/2609.34472/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 34 of its 66 references that are in the map.
- First posted on arXiv 28 Sep 2026.

## Builds on (most cited first, 30 of 34)

- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [Training data-efficient image transformers & distillation through attention](https://mlsanity.com/paper/2012.12877/) (2020)
- [Scaling Up Visual and Vision-Language Representation Learning With Noisy Text Supervision](https://mlsanity.com/paper/2102.05918/) (2021)
- [Encoder-Decoder with Atrous Separable Convolution for Semantic Image Segmentation](https://mlsanity.com/paper/1802.02611/) (2018)
- [SegFormer: Simple and Efficient Design for Semantic Segmentation with Transformers](https://mlsanity.com/paper/2105.15203/) (2021)
- [Pyramid Scene Parsing Network](https://mlsanity.com/paper/1612.01105/) (2016)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [UNet++: A Nested U-Net Architecture for Medical Image Segmentation](https://mlsanity.com/paper/1807.10165/) (2018)
- [Conditional Prompt Learning for Vision-Language Models](https://mlsanity.com/paper/2203.05557/) (2022)
- [Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2105.05537/) (2021)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [RegionCLIP: Region-based Language-Image Pretraining](https://mlsanity.com/paper/2112.09106/) (2021)
- [MediaPipe: A Framework for Building Perception Pipelines](https://mlsanity.com/paper/1906.08172/) (2019)
- [Extract Free Dense Labels from CLIP](https://mlsanity.com/paper/2112.01071/) (2021)
- [Open-Vocabulary Semantic Segmentation with Mask-adapted CLIP](https://mlsanity.com/paper/2210.04150/) (2022)
- [PraNet: Parallel Reverse Attention Network for Polyp Segmentation](https://mlsanity.com/paper/2006.11392/) (2020)
- [Open-Vocabulary Panoptic Segmentation with Text-to-Image Diffusion Models](https://mlsanity.com/paper/2303.04803/) (2023)
- [CRIS: CLIP-Driven Referring Image Segmentation](https://mlsanity.com/paper/2111.15174/) (2021)
- [LAVT: Language-Aware Vision Transformer for Referring Image Segmentation](https://mlsanity.com/paper/2112.02244/) (2021)
- [WinCLIP: Zero-/Few-Shot Anomaly Classification and Segmentation](https://mlsanity.com/paper/2303.14814/) (2023)
- [CE-Net: Context Encoder Network for 2D Medical Image Segmentation](https://mlsanity.com/paper/1903.02740/) (2019)
- [CAT-Seg: Cost Aggregation for Open-Vocabulary Semantic Segmentation](https://mlsanity.com/paper/2303.11797/) (2023)
- [LViT: Language meets Vision Transformer in Medical Image Segmentation](https://mlsanity.com/paper/2206.14718/) (2022)
- [VLT: Vision-Language Transformer and Query Generation for Referring Segmentation](https://mlsanity.com/paper/2210.15871/) (2022)
- [SED: A Simple Encoder-Decoder for Open-Vocabulary Semantic Segmentation](https://mlsanity.com/paper/2311.15537/) (2023)
- [Can CNNs Be More Robust Than Transformers?](https://mlsanity.com/paper/2206.03452/) (2022)
- [MedCLIP-SAM: Bridging Text and Image Towards Universal Medical Image Segmentation](https://mlsanity.com/paper/2403.20253/) (2024)

## Abstract (arXiv)

Acne assessment is crucial for clinical decision-making, yet traditional grading and counting are subjective and fail to account for lesion size. While area-based assessment has emerged as a promising alternative, acne segmentation has continued to rely on general-purpose architectures. To address this gap, we propose VL-AcneSeg, a multimodal framework for acne lesion segmentation that leverages CLIP and region-level text prompts to incorporate spatial priors, enabling lesions to be localized across the whole face. Because region-level prompts indicate which facial areas contain lesions, we report a single global prompt, which requires no such information, as our primary setting. On our internal clinical dataset, VL-AcneSeg achieves a Dice score of 0.5082 and an IoU of 0.3407 under this protocol, the highest among all compared methods, including recent vision-language segmentation methods that are themselves given region-level prompts; region-level prompting raises these to 0.5296 and 0.3602. Moreover, lesion area measurements derived from our segmentation correlate with IGA scores at a level comparable to expert annotations (Pearson r = 0.719 versus 0.658). Notably, our framework maintains consistent performance across external validation datasets, performing reliably even on uncontrolled smartphone images without requiring additional training or fine-tuning. By pairing a protocol that requires no lesion-location information with area-based severity estimation, this work provides a foundation for objective acne assessment outside the clinic. Our implementation is publicly available at: https://github.com/sukjuoh/VL-AcneSeg