Acne is a hallmark of adolescence, affecting 85% of youth between the ages of 12 and 25 worldwide. Perhaps because of its ubiquity and minimal impact on physical functioning, acne is often dismissed as a time-delimited cosmetic nuisance and has been summarily neglected by developmental scientists. However, emerging evidence suggests that acne is associated with clinically significant psychological adjustment problems, including depression and anxiety. Adopting an interdisciplinary approach that bridges developmental and dermatological science, we reposition acne as a prominent source of psychological maladjustment and health disparities in adolescence. Specifically, we propose that females and youth with darker skin may be disproportionately affected by the pernicious psychological effects of acne. Reconceptualizing adolescent acne as a developmentally and psychologically meaningful dermatologic disease with effects shaped by culture and health care disparities will advance our understanding of youth's mental health.