Indications to refer a patient with acne to a dermatologist:
(1) severe form of acne with systemic symptoms (acne fulminans)
(2) failure of moderate or severe acne to respond adequately to optimum topical and systemic care
(3) risk of significant cosmetic scarring or disfigurement, especially if appearance is essential to livelihood
(4) severe form of acne with indications for isotretinoin therapy
Indications to refer a patient with acne to an endocrinologist:
(1) polycystic ovary disease or other endocrine disorder that may be contributing to the disorder and making it hard to control
Indications to refer a patient with acne to a psychiatrist:
(1) severe psychiatric (anxiety, phobia, depression) or social problems as a result of the acne
Indications to refer a patient with acne to a plastic or cosmetic surgeon:
(1) significant cosmetic scarring (although treatment may need to be delayed until acne is controlled)
