OBJECTIVE: We aimed to evaluate the relationships between acne severity, anxiety, depression and disease-specific quality of life in patients with acne. METHOD: A total of 61 patients with acne vulgaris and 38 healthy volunteers were included in the study. Acne severity was assessed by the Global Acne Grading System. All patients were asked to complete the Acne Quality of Life Scale (AQOL), Dermatology Life Quality Index (DLQI) and Hospital Anxiety and Depression Scale (HAD), and healthy controls to fill only the HAD. RESULTS: The mean HAD anxiety subscale (HAD-A) and HAD depression subscale (HAD-D) scores of the patients were significantly higher than those of the controls. The rates of subjects at risk for anxiety (26.2%) and for depression (29.5%) were significantly higher in the patient group than in the control group (0% and 7.9%, respectively). We found no correlations between acne severity and scores of AQOL, DLQI, HAD-A and HAD-D. AQOL and DLQI scores were positively correlated with HAD-A and HAD-D scores in the patient group. The patients at risk for anxiety had significantly higher scores on AQOL and DLQI compared to those who were not at risk. There were no statistically significant differences between the female and male patients with respect to AQOL, DLQI, HAD-A and HAD-D scores. CONCLUSION: (1) Irrespective of the degree of severity, patients with acne are at increased risk for anxiety and depression compared to the normal population. (2) Acne negatively affects quality of life, and the greater the impairment of quality of life due to acne, the greater the level of anxiety and depression. (3) A greater impairment of dermatologic quality of life seems to put the patient at an increased risk for anxiety disorder.