Acne may vary from a relatively trivial condition to a severe disfiguring disease and management must be tailored to suit individuals. Pathogenetic factors that may be addressed by treatment include increased sebum secretion, abnormal follicular keratinisation, bacterial colonisation and local inflammation.Mild acne can be controlled with topical preparations alone but many patients with more severe disease require oral therapy with antibiotics, antiandrogens or retinoids. Combinations of topical and systemic treatments are often appropriate. The choice of drug requires knowledge of their efficacy, ease of use and possible adverse effects.