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AI may help organize acne photos or support a clinician’s review, but in a clinician-led service it does not replace the clinician’s diagnosis or prescribing judgment. An online evaluation may use photos and a written history, a live video or phone visit, or a combination; whether it leads to a prescription depends on the clinician’s assessment and the service’s process.
What happens during an online acne evaluation?
Teledermatology can happen in real time, through video or telephone, or asynchronously, when a patient securely submits photos, a description of the concern, and relevant health information for later review. The exact process varies by service and by the clinical situation.
A clinician may ask how long the breakouts have been present, what treatments have been tried, which medicines the patient currently takes, and whether there are allergies or other relevant health conditions. The clinician then considers that history alongside the visible skin findings. The American Academy of Dermatology (AAD) says its teledermatology standards call for providers to be able to collect and review medical history and document the encounter; it also recommends adequate history and examination before prescribing. Read the AAD teledermatology standards.
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What role can AI play?
Depending on a product’s design, AI may assist with analyzing images, organizing information, or offering decision support. That does not establish that an app can diagnose a particular person, nor that all online acne services use AI or use it in the same way.
The FDA’s software guidance discusses whether a healthcare professional can independently review the basis for a software recommendation. How a product is treated depends on its intended use and actual functionality—not simply on whether it is described as “AI.” See the FDA guidance on clinical decision-support software.
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The AAD cautions that consumer apps offering skin diagnoses or treatment plans can be inaccurate and says rigorous testing should establish performance across skin tones. This is a general warning about app claims, not evidence that every tool performs poorly—or that any particular acne tool has been validated. The available evidence here does not establish an accuracy figure for AI acne diagnosis. Read the AAD’s guidance on skin-diagnosis apps.
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Why a clinician’s assessment matters
Acne is usually diagnosed by examining the type and distribution of breakouts, but other conditions can look similar. The AAD identifies folliculitis and perioral dermatitis as examples that may be mistaken for acne. A clinician can consider the appearance and medical history together, decide whether acne is likely, and determine whether another diagnosis or an in-person examination needs consideration. Learn how acne is diagnosed and treated.
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There is no single best acne treatment for everyone. The AAD’s 2024 guideline supports several options, including benzoyl peroxide, topical retinoids, topical antibiotics, oral antibiotics, hormonal therapies, and isotretinoin in appropriate cases. It supports combining topical mechanisms in many treatment plans and limiting systemic antibiotic use where possible. These are clinician-guided options, not a menu that an online questionnaire can match to every patient or a promise that a particular drug will be prescribed. See the AAD acne clinical guideline.
Why isotretinoin is a clear example
Isotretinoin is an option for severe acne, but prescribing it involves more than matching a photo to a medication. The AAD says clinicians evaluate health history and tests, discuss benefits and risks, and monitor patients. Its guidance describes follow-up at 30-day intervals, which may take place by telemedicine subject to applicable safety-program requirements. Requirements can vary by jurisdiction and change over time, so patients should confirm current rules with their clinician and the relevant program. Read the AAD’s isotretinoin guidance.
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How to assess an online acne service
Before sharing images or relying on an online recommendation, check whether you can identify who will review your case and how the service handles situations that need more than remote care. The AAD says telemedicine can help with visible skin conditions, including acne, but cannot always replace an in-person appointment.
- Clinician and location: Can you identify the clinician and credentials, and verify that the clinician is licensed where you are located?
- Information reviewed: Can you provide relevant medical history and clear photos when needed, and is there a way to answer follow-up questions?
- Escalation: Does the service explain how to arrange an in-person dermatology visit if the remote assessment is insufficient?
- Privacy: Before uploading photos or health information, review how the service collects, uses, and protects them.
- AI claims: If the service describes its software as diagnostic, look for information about its intended role and evidence of performance rather than treating the label “AI” as proof of accuracy.
The AAD states that it does not support teledermatology services that put business interests ahead of care quality and safety, including platforms not supervised by board-certified dermatologists or that offer no option for an in-person visit with a board-certified dermatologist when needed. Review the AAD’s standards.
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When might an online visit need to become an in-person visit?
A remote visit may not provide enough information to distinguish acne from a look-alike condition or to assess a presentation that requires closer examination. The clinician may ask for clearer or additional images, arrange a live consultation, or recommend an in-person visit. Telemedicine is a way to access care, not a guarantee that every concern can be resolved remotely.
The AAD reports that nearly 50 million Americans are affected by acne each year. Its 2024 guideline update provides evidence-based recommendations for dermatologists and other clinicians caring for patients with acne. Read the AAD’s announcement of the updated acne guidelines.
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