The author reviews the evidence surrounding acne development, prevalence and assessment, discussing the importance of capturing a detailed patient history, with reference to aspects of the author’s own assessment tool. The crucial role of the pilosebaceous unit in relation to acne is described and the author reinforces the complex pathogenesis of acne vulgaris through a detailed discussion of the aetiological factors with emphasis placed on early intervention following symptom onset to reduce the risk of associated complications. A comprehensive overview of a physical examination of the skin is conveyed, including the importance of requesting laboratory testing in female patients with dysmenhorrea or hirsutism, including cases of refractory treatment. The author describes the lesion types and severity through defining the categories of acne as well as a variety of differential diagnoses. Emphasis is placed on performing a holistic assessment of the acne patient, with reference to several robust questionnaires to assess the psychosocial disease impact, for example, the Dermatology Life Quality Index (DLQI). This is a detailed and useful overview of acne vulgaris for aesthetic nurses, underpinned by current evidence to reinforce the complexity of the condition, the importance of prompt diagnosis and referral to a dermatologist, where necessary.