BACKGROUND: The attention to the impact of gender differences in acne is needed and lacking OBJECTIVE: To perform a systematic review on gender differences in acne METHODS: A review of literature was performed using PubMed and Ovid literature search, using a variety of combined search terms including ''acne'' ''gender,'' ''sex,'' ''females,'' ''males,''. The search extends until July 2013. RESULTS: Gender differences in acne highlight hormonal interactions as a major target for which more research is needed to translate current findings to clinically significant diagnostic and therapeutic applications. In addition female patients are more likely to develop anxiety and depression due to their condition, and acne improvement positively influences quality of life. CONCLUSIONS: The patient's sex should not radically alter diagnostic or therapeutic efforts, although gender differences could be necessary to set up clinical management, monitoring also the psychological aspect.