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Acne detection is crucial for interpretative diagnosis and precise treatment of skin disease. The arbitrary boundary and small size of acne lesions lead to a significant number of poor-quality proposals in two-stage detection. In this paper, we propose a novel head structure for Region Proposal Network to improve the proposals' quality in two ways. At first, a Spatial Aware Double Head(SADH) structure is proposed to disentangle the representation learning for classification and localization from two different spatial perspectives. The proposed SADH ensures a steeper classification confidence gradient and suppresses the proposals having low intersection-over-union(IoU) with the matched ground truth. Then, we propose a Normalized Wasserstein Distance prediction branch to improve the correlation between the proposals' classification scores and IoUs. In addition, to facilitate further research on acne detection, we construct a new dataset named AcneSCU, with high-resolution imageries, precise annotations, and fine-grained lesion categories. Extensive experiments are conducted on both AcneSCU and the public dataset ACNE04, and the results demonstrate the proposed method could improve the proposals' quality, consistently outperforming state-of-the-art approaches. Code and the collected dataset are available in https://github.com/pingguokiller/acnedetection.