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Personal Medical History for acne – Women

The test and evaluation is based on International Medical Standards.

Fields with * are required

1.Which area(s) have acne and is going to be treated?

Please specify:

2. Description of lesions

3. Skin type

4. Could it be inherited (do your parents have or had acne)?

5. At what age was the onset of acne?

6. Have you received topical treatment in the past?

7. Have you received oral medications in the past?

8. Do you have a history of photosensitivity?

9. Do you use any acne treatment at the moment?

10. Do you use cosmetic products for acne-prone skin?

11. Do you receive oral contraceptives?

12. Do you have Polycystic Ovaries?

13. Are you pregnant, trying to have a baby or breastfeeding?

14. Do you use make-up or other cosmetic products on your face?

According to medical confidentiality, we are committed to maintaining the privacy of medical and personal information entrusted to us and these data will not be published or otherwise used apart from the purposes of this assessment.

Bibliography / Sources
Acne Management in Three Steps
  1. Get informed about the available treatment options
  2. Follow the appropriate treatment for you
  3. Avoid habits leading to acne recurrence
Acne:
Why me?

Acne may occur independently of your gender and age...

What should I
change?

The first step is to find information about the available...

How can it be treated?

There are many available options for the...