Acne Tests & Diagnosis

When to See a Doctor

Many cases of acne will clear up with over-the-counter treatments. If your acne bothers you for more than a few weeks or months, you should go see a doctor for follow-up tests and prescription medicines. You can choose to see a primary care physician or dermatologist.

If you see a general practitioner, he or she may refer you to a specialist who has in depth experience with a variety of skin conditions. A specialist who has experience with a variety of skin conditions will be in a good position to treat your symptoms and determine whether your skin is breaking out as a result of acne or another infection.

Some people need to see a dermatologist regularly for a period of months or years. Even if you have completed a treatment plan for your acne, you may need to continue seeing the dermatologist.

Visual Tests

A doctor is able to visually diagnose acne by visual inspection. In general, tests are not necessary. A doctor can diagnose types of acne and can assess treatments for acne by examining the skin.

Tests are required to assess what treatments are most effective. When selecting a treatment, a doctor makes judgments based on personal experience, recommended routines, and standard protocol. In any case, the success of treatments can vary from person to person. To some extent, a doctor might try experimenting with treatments in order to test which one is the most effective for the patient's individual needs. During this process, it is important that the patient remains proactive and observant.

Sometimes, the treatments may not work. Several bacterial and fungal infections resemble acne, and many of these alternative conditions go undiagnosed because they are mistaken for acne. At first glance, these conditions are indistinguishable from mild, moderate, and severe forms of acne.

If you are not responding to prescribed acne treatments, then the doctor may need to order additional tests such as blood tests and skin biopsies to rule out other possible conditions.

Blood and Urine Tests

Sometimes, additional tests are required to check for underlying conditions. Blood tests and urine tests help detect abnormal hormone levels and elevated hormone levels that result from conditions like polycystic ovary syndrome and Cushing's syndrome.

Blood tests and urine tests will check both male and female hormones in addition to cortisol, a hormone related to stress. Certain tests can also assess whether androgen (male sex hormone) levels are elevated. Tests can also assess whether the female sex hormones, estrogen and progesterone, are present at levels that can affect acne.

Certain thyroid tests can measure whether the endocrine system is functioning property. The endocrine glands are regulated by the hypothalamus and pituitary glands, which are located in the brain. These glands are all responsible for hormone regulation in both males and females.

Skin Biopsy

A skin biopsy can help assess other problems like psoriasis, for example. With a skin biopsy, the doctor removes a piece of skin tissue to observe under a microscope. Typically, a doctor will perform a skin biopsy after all other tests return normal or inconclusive results. Sometimes, a doctor might choose to perform a skin biopsy immediately if he or she suspects that the acne could be an underlying bacterial or fungal infection.

Psoriasis is one condition that can produce similar symptoms of acne. The condition is non-contagious but can resemble a variety of other skin infections and sexually transmitted diseases. Psoriasis is a lifelong condition and cycles through flare-ups and periods of remission. Most people experience their first outbreaks as adolescents around the age of 15, about the time when it is common to experience mild, moderate, and severe acne. As with acne, the severity of psoriasis can also range.

A skin biopsy can help distinguish acne from psoriasis. A microscope will allow medical professionals to observe the skin more closely and identify characteristics of acne or another condition.

With an excision biopsy, a large portion of skin needs to be removed for analysis. With a punch biopsy, a sharp instrument will remove a portion of skin that is shaped as a cylinder. A doctor might also use a scalpel to save the outside of one or several lesions.