A retrospective questionnaire was conducted as to the risk factors for facial skin cancer with emphasis on acne and past treatments for acne, in particular use of benzoyl peroxide preparations. The response rate was 90.9% for 964 cases and 79.9% for 3856 controls. There was no association between acne and the use of any acne medication for the risk of facial skin cancer. Cases of skin cancer were significantly more likely to have used phototherapy or sunbeds than the controls (P = 0.024), and more likely to have had radiotherapy prior to diagnosis (P = 0.001). The major risk factors as determined by generalized linear interactive modelling were family history of skin cancer (odds ratio 2.68; 95% confidence interval 2.15, 3.34), light skin (1.54; 1.25, 1.89), sunburning easily (1.43; 1.16, 1.76) and Irish, Scottish, Scandinavian or German mothers (1.33; 1.11, 1.59).