Acne is a common condition seen routinely by both primary care physicians and dermatologists. Most patients have no underlying pathology and respond to traditional treatment; others, however, require more individualized evaluation and aggressive therapy. New information regarding the pathogenesis and treatment of acne is now available. This update discusses the proper evaluation of early childhood acne, the emergence of Propionibacterium acnes resistance, and the rare but serious side effects occasionally seen with minocycline. Advances in the topical treatment of acne, the use of oral contraceptives in acne, and the use and efficacy of isotretinoin are also addressed.