Acne is a chronic inflammatory dermatologic disorder commonly affecting adolescent population. If begins in childhood before twelfth year or before menarche in girls it is called acne in childhood. This group of acne patients may be categorized into the four clinical entities based on the time of onset: neonatal acne, infantile acne, mid-childhood acne and preadolescent acne. Pathophysiology of neonatal acne is only partially understood, while other types of acne may be caused by underlying hormonal abnormalities that should be considered. Therefore, diagnostic approach is based on endocrinology processing which is very important for the mid-childhood acne. There are three basic clinical forms of acne: comedonal acne, papulopustular acne and nodular/conglobate acne. Therapeutic approach depends on the severity of the clinical presentation and the patient’s age. Neonatal acne doesn’t require the treatment except in case of neonatal cephalic pustulosis when topic azoles are used. Therapy of other types of acne consists of topical application of benzoyl peroxide, antibiotics and retinoids or their combination; while in severe forms systemic antibiotic therapy is applied. Isotretinoin is used in the most severe forms. Topical retinoids are the first choice of maintenance therapy. Timely administered therapy and education of parents and children are the foundation of reaching the therapeutic success.