This study examined appearance-related distress in patients with acne. One hundred and thirty-two people attending a specialist acne clinic completed questionnaires including the Derriford Appearance Scale and three self-rated acne scales covering more (facial) and less visible (chest, back) acne sites. Women with acne demonstrated greater self-consciousness of appearance and negative self-concept than men. Subjective rating of severity of facial acne was significantly associated with increased social self-consciousness in women, but not in men. Back acne was significantly associated with sexual and bodily self-consciousness of appearance in both men and women. Patients 20 years and above were significantly more likely to suffer appearance-related distress than 16-19-year-olds. Although not a key focus of this study, ethnicity was also implicated in appearance concern arising from acne.