A multiphysics approach, combining acoustics, optics, and mechanics can be used to detect regions of skin with distinct mechanical behavior that may indicate a pathology, such as a cancerous skin lesion. Herein, an acousto-optical approach to evaluating the viscoelastic behavior of superficial skin layers will be presented. The method relies upon inducing low frequency guided surface waves in the skin and detecting these waves by monitoring the shift in the backscattered laser speckle pattern created by illuminating a small region of the skin with coherent light. Artificial lesions in the form of chemical cross-linking and chemical softening were induced in superficial porcine skin layers and detected based upon variations in local mechanical behavior. The lesions affect not only the time-of-flight of the guided surface waves, but also change the relative phase of the acoustic waves as determined optically. The method may be applicable in the study and diagnosis of superficial skin lesions.