Studies investigating the possible role of personality and emotional factors in acne patients have yielded inconsistent and sometimes contradictory results. In the present study acne patients self-rated the severity of their conditions as mild, moderate, or severe and were compared to a control group on several personality variables. These self-ratings were compared to the objective ratings made by their dermatologists. Acne patients who self-rated their conditions as severe were found to experience significantly higher levels of trait anxiety than patients with mild and moderate conditions and control subjects; patients with severe and moderate conditions showed a higher state of anxiety than control subjects. Acne patients rated as severe by their dermatologists showed higher states of anxiety, "anger-in," and "anger-out" than the others. No other significant differences in terms of severity emerged, supporting the view that acne patients are not markedly neurotic. The results suggest that anxiety and anger are significant factors for severe acne patients and that future research should include severity ratings from both patients and physicians in the research design.