Crossword Genius

Spots note inside card (4)

Ross

I believe the answer is:

acne

'spots' is the definition.
(skin condition causing spots)

'note inside card' is the wordplay.
'note' becomes 'n' (abbreviation).
'inside' is an insertion indicator.
'card' becomes 'ace' (ace is a type of playing card).
'n' inserted within 'ace' is 'ACNE'.

(Other definitions for acne that I've seen before include "Problem to face in" , "Skin problem, mainly of teenagers" , "Cane for the teenager?" , "Skin affliction" , "Skin condition prevalent among teenagers" .)

I've seen this clue in The Telegraph.
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