OBJECTIVES: Acne vulgaris is one of the most common skin conditions, affecting primarily the adolescents. This disorder is characterized by an abnormal functioning of the pilosebaceous follicle causing different types of lesions. The objectives of the present study were to determine the prevalence of acne in adolescents in Europe and evaluate the impact of environmental and lifestyle factors on this condition. METHODS: A survey was conducted in a sample of individuals residing in Europe and aged 15 to 24. To ensure representativeness, the quota method was applied considering age, sex, residence location and occupational status of the reference person. Study participants were asked to complete a specifically developed questionnaire online, on two occasions separated by 6 months (not reported here). RESULTS: A total of 10 521 questionnaires were completed yielding an self-reported average prevalence of acne of 57.8% in European adolescents. However, there were variations across countries, prevalence rates ranged from 42.2% in Poland to 73.5% in Czech Republic and Slovakia. Results from a multivariate regression demonstrated that heredity is a risk factor for developing acne whereas age appears to be protective. Indeed, in all selected countries, a decrease in the prevalence of acne associated with age was observed. Highest rates were reported in the age group 15-17 and lowest in the age group 21-24. Among the lifestyle factors investigated, only tobacco and chocolate consumption were associated with acne. Indeed, the former seems to prevent acne whereas the latter was associated with a higher probability of experiencing the condition. CONCLUSIONS: The self-declared prevalence of acne is relatively high in European adolescents even if there are variations across countries. Heredity is the main identified risk factor for developing acne whereas age is negatively associated with the prevalence of this condition.