Acne vulgaris is a common disorder of the pilosebaceous unit affecting adolescents and adults. The rise in incidence of acne in the United States may relate to the Western diet--which is rich in dairy and refined sugars, and high in glycemic load--and to the obesity epidemic. We reviewed the literature on diet and acne. Evidence exists highlighting the association of acne and high glycemic loads, certain dairy products, and refined sugar product ingestion. Future studies are required to determine if dietary modification will reduce long-term acne burden.