Acne vulgaris is a nearly universal phenomenon among adolescents in the western world and continues to remain problematic for a significant proportion of adults. During adolescence, emotional and physical changes must be successfully integrated into the emerging sense of self, and skin disorders such as acne, which alter that self-image, may engender distressing feelings of embarrassment, shame, and disgust. While most patients eventually achieve spontaneous remission, approximately one quarter of teenagers will show evidence of permanent acne scarring by 18 years of age. This article reviews current information regarding the pathophysiology, clinical manifestations, differential diagnosis, and therapy of the adolescent patient who has acne, and emphasizes recent advances in acne management.