Updated 15 July 2014

Diagnosing acne

Acne is easily diagnosed by physical examination and medical history.


Acne is easily diagnosed by physical examination and medical history.

When signs of androgen excess are present such as menstrual irregularity, hair loss on the scalp and hair growth on the body, specialist referral is essential to exclude overproduction of androgenic hormones by the ovaries or adrenal glands.

The diagnosis of acne is usually straightforward, but acne-like lesions may be caused by systemic medication (e.g. cortisone), cortisone applied to the face, and, greasy cosmetics.

Rosacea is characterised by redness, red bumps and pimples. Comedones are absent. Patients are usually middle aged.

When to see a doctor

•    In all cases of inflammatory acne
•    If non-inflammatory acne gets worse or does not respond to home treatment within two to three months.
•    If you develop emotional problems as a result of your acne.
•    If you develop scars or marks on your skin after a pimple has healed.
•    If your pimples become large and hard or filled with fluid.
•    If you notice other symptoms, such as hair growth on the chin (if you’re a woman) or bone and muscle pain (both sexes) or any other sign of overproduction of androgens.
•    If you suspect new prescription medication causes your acne.
•    If you suspect that greasy cosmetics or other topical preparations are aggravating your acne.

(Reviewed by Prof H.F. Jordaan, MBChB, MMed (Derm), September 2004)

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