Androgenetic Alopecia (Female Pattern Hair Loss): This condition is common in women and can present with hair thinning, particularly on the top of the scalp. The presence of mild acne could be coincidental or related to hormonal fluctuations, but the lack of hirsutism and correlation with menstrual cycles makes a significant hormonal imbalance less likely.

Polycystic Ovary Syndrome (PCOS): Although the patient denies hirsutism and correlation with menstrual cycles, PCOS can present variably. Some women with PCOS may not exhibit all the classic symptoms, such as hirsutism or irregular periods, but could still experience acne and hair loss due to androgen excess.
Thyroid Disorders: Both hypothyroidism and hyperthyroidism can cause hair loss. Thyroid disorders are relatively common and can present with skin and hair changes, among other symptoms.
Telogen Effluvium: This is a condition that can be triggered by stress, leading to a significant increase in hair shedding. It's possible that the patient has experienced a stressful event recently, which could contribute to her hair loss.

Adrenal or Ovarian Tumors: Although rare, these tumors can produce excess androgens, leading to symptoms like acne and hair loss. It's crucial to consider these diagnoses due to their potential impact on health if left untreated.
Pituitary Tumors: Tumors affecting the pituitary gland can disrupt hormone production, potentially leading to symptoms like hair loss and acne. Early detection is critical for effective management.
Autoimmune Disorders (e.g., Alopecia Areata, Lupus): These conditions can cause hair loss and may be associated with other systemic symptoms. While less common, they are important to consider due to their potential for significant morbidity.

Congenital Adrenal Hyperplasia (Late-Onset): This is a rare genetic disorder affecting the adrenal glands, leading to an imbalance in hormone production. It could potentially cause symptoms like acne and hair loss, although it's less likely in a patient without a known family history or other suggestive symptoms.
Hair Loss Due to Infection or Infestation (e.g., Ringworm of the Scalp): Although less common in adults, fungal infections can cause hair loss. This would typically be accompanied by other scalp symptoms like itching, redness, or flaking.

Can you describe the pattern of your hair loss? Is it primarily on the top of your scalp or more evenly distributed?
Have you noticed any changes in your skin besides acne, such as increased oiliness or dryness?
Have you experienced any weight changes, fatigue, or other systemic symptoms?
Do you have a family history of hair loss, thyroid problems, or autoimmune diseases?
Have you recently experienced significant stress or changes in your lifestyle?
Are you open to further testing, such as blood work to check your hormone levels or thyroid function, if necessary?