Background Since adolescents are psychologically more unstable, the emergence of acne vulgaris during adolescence makes this disease a focal point of concern for many individuals. Aim In this study, psychiatric comorbidity and levels of self-injurious behavior, suicide probability, life satisfaction, self-esteem and loneliness in adolescents with acne was assessed and compared with a control group. Methods The study was conducted with 104 adolescents with acne and 102 age- and sex-matched healthy controls. The Rosenberg Self-Esteem Scale, Suicide Probability Scale (SPS), Life Satisfaction Inventory, Short form of the UCLA Loneliness Scale and Inventory of Statements About Self-Injury (ISAS) were administered to the case and control groups. Both groups were assessed according to the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version-Turkish Version. Results Adolescents with acne were found to have lower levels of self-esteem and life satisfaction and higher levels of loneliness compared to controls. The mean scores of SPS and its negative self-evaluation/hostility subscales were found to be significantly higher in adolescents with acne. The presence of self-injurious behavior and psychiatric comorbidity were shown to be significantly higher in adolescents with acne. Conclusions The presence of high levels of psychiatric comorbidity, suicide probability, and self-injurious behavior in adolescents with acne in our study suggests that psychiatric evaluation should be included in acne treatment plans. Psychological assessment of adolescents with acne vulgaris is important for contributing to the detection of any potential covert sexual abuse. Our study demonstrates the importance of a multidisciplinary approach for acne treatment.