Abstract: Background: Acne vulgaris is a very common disease process that is seen frequently by both pediatricians and dermatologists. However, treatment may be different depending on specialty. Objectives: To compare pediatricians’ and dermatologists’ patterns of treatment for acne vulgaris. Methods: National Ambulatory Medical Care Survey data on office visits to pediatricians and dermatologists for acne vulgaris were analyzed from 1996 to 2005. Results: During this 10-year time period, dermatologists managed an estimated 18.1 million acne visits and pediatricians managed an estimated 4.6 million acne visits. Dermatologists prescribed topical retinoids considerably more frequently than did pediatricians (46.1% of acne visits for dermatologists vs 12.1% for pediatricians). Conclusions: There is an opportunity for pediatricians to play a greater role in the management of patients with acne. A shift toward greater use of topical retinoids by pediatricians would be more in line with the practice of dermatologists and with current acne treatment consensus guidelines.