OBJECTIVES: Acne is a common condition for which multiple treatment options are available.  The patterns of pharmacotherapy for acne and similar conditions, and the effect of those patterns on cost, are not well characterized. This study examined the impacts of patient demographics and medication choices on patient’s health status and associated medication costs. METHODS: A retrospective cross-sectional study was conducted using the 2007 Medical Expenditure Panel Survey (MEPS) database. Information on patient demographics, health status, medication utilization, and medication costs were obtained from the database representing 3,784,816 patients with acne and similar conditions. RESULTS: Weighted multiple linear regression analyses indicated that the use of topical retinoids was preferred in combination with other treatments rather than its monotherapy. Oral antibiotics were widely prescribed and its use was associated with a significant decrease in total annual prescription spending.  Use of oral retinoids and oral contraceptives increased the annual prescription costs significantly. Increase in annual drug refills was not associated with the improvement in health status. CONCLUSIONS: We observed an association with medication choice for acne and acne related conditions on medication spending. Pharmacologic treatment of acne significantly adds to acne related annual healthcare costs compared to non pharmacologic treatment.