Card carrying first of nine spots (4)
I believe the answer is:
acne
'spots' is the definition.
(I've seen this before)
'card carrying first of nine' is the wordplay.
'card' becomes 'ace' (I've seen this before**).
'carrying' indicates putting letters inside.
'first of' suggests taking the first letters.
The initial letter of 'nine' is 'n'.
'ace' placed around 'n' is 'ACNE'.
(Other definitions for acne that I've seen before include "Spotty coverage" , "Skin condition prevalent among teenagers" , "Spotty skin condition" , "Pimply ailment of adolescnce" , "Facial spots" .)