Dermal dilemma (4)
I believe the answer is:
acne
'dermal dilemma' is the definition.
(I've seen this in another clue)
This is the entire clue.
(Other definitions for acne that I've seen before include "Facial spots" , "Skin affliction" , "(Inflammation causing) spots" , "Teenage spots" , "Skin condition prevalent among teenagers" .)