Adolescence is an important period for emotional and psychosocial development and considerable changes occur to self-consciousness. Low self-esteem in adolescence has been associated with delinquency, aggression, antisocial behavior, poor physical and emotional health, and lower economic success in adulthood compared to individuals with high self-esteem. This study focuses on how acne, a disease process that affects more than 85% of adolescents, impacts self-esteem in this patient population. We conducted a literature review for studies evaluating the impact of acne on adolescent self-esteem. Five studies that specifically focused on acne and self-esteem in the adolescent population were selected for complete review. All of the studies found a correlation between adolescent acne and low self-esteem and the majority of acne patients surveyed across all 5 studies reported dissatisfaction with their appearance and demonstrated more emotional disturbance than their peers without acne. Patient perception of disease severity was found to be the most important and universal indicator of low self-esteem. Acne treatment was associated with improvement in self-esteem. Early and aggressive treatment can have a positive impact on self-esteem in adolescents with acne, and it is important to consider a patient’s perception of his/her disease severity when selecting a treatment regimen. The high correlation between acne and psychosocial problems in adolescents indicates that it is imperative to assess patients for low self-esteem and depression prior to treatment.