How is it Diagnosed?
Acne is a chronic inflammatory skin condition involving the pilosebaceous units,
common in adolescents and young adults. Diagnosis is clinical, based on the presence
of comedones (open and closed), papules, pustules, nodules, and cysts, typically on the
face, chest, and back.
A thorough medical and dermatological history helps identify potential contributing
factors like hormonal changes, stress, diet, cosmetic use, and medications (e.g.,
corticosteroids, androgens). Family history and menstrual irregularities in females may
suggest a hormonal etiology.
The severity of acne (mild, moderate, or severe) is assessed based on lesion type and
distribution. Hormonal evaluation (testosterone, DHEAS, LH/FSH ratio) may be indicated
in females with signs of hyperandrogenism, such as hirsutism, irregular menses, or
sudden onset severe acne, to rule out PCOS or adrenal disorders.
Skin swabs or cultures are rarely needed unless there’s suspicion of superimposed
bacterial infection. Scarring assessment is also essential to plan long-term treatment
strategies.
Dermatologists often use standardized grading scales, such as the Global Acne Grading
System (GAGS), to quantify acne severity for treatment planning and follow-up. The
diagnosis is generally straightforward and does not require biopsy or imaging unless
atypical features or treatment resistance is present.